60例食管癌手术治疗诊治分析  

Diagnosis and Treatment Analysis of 60 Cases of Esophagus Cancer

作　　者：于占武[1] 玉寒冰[1] 马业罡[1] 王伟[1] 李少波[2] 

机构地区：[1]辽宁省肿瘤医院胸外科,辽宁沈阳110001 [2]第三军医大学临床医学系,重庆400038

出　　处：《现代生物医学进展》2013年第30期5922-5924,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30872464)

摘　　要：目的:探讨胸段食管癌三种常用术式方法的选择原则、手术疗效及术后并发症的比较。方法:本研究选择临床确诊无广泛转移胸段食管癌60例,分别采用常规左胸入路手术20例,右胸、上腹部二切口手术18例和右胸、腹、颈部三切口手术22例,均为根治性手术,术中清扫淋巴结,并送病理检查。分析不同手术径路对食管癌治疗效果及术后并发症的影响。结果:本组研究病例全部顺利完成根治性手术,术中淋巴结活检检出有淋巴结转移25例,淋巴结转移率41.67%(25/60)。本研究组发生并发症患者13例,其中吻合口瘘4例,胃排空障碍4例,肺部并发症5例。其中通过右胸、腹、颈部三切口入路手术并发症最高,达41.25%,与其它组别相比均有明显差异,P<0.05。结论:胸段食管癌手术方式的选择应因人而异,正确的选择有助于提高肿瘤切除率、淋巴结清扫率及降低肿瘤复发率,此外不同手术方式的个体化选择是降低术后并发症和提高生存质量的有效手段。Objective： To discuss the selection principal, operation effects and complications after operation in three different operation methods. Methods： The 60 cases of patients were diagnosed of thoracic segment esophageal carcinoma without other pulmonary and circulation diseases. Among them, 20 cases were adopted by conventional surgery from left breast, 18 cases by right thoracolaparotomy approach surgery（2 incisions） and 22 cases by right thoracolaparotomy and cervical approach surgery（3 incisions）.All of these are radical operation, and the lymph nodes were sent for pathology. The aim is to investigate the treatment effects and complications in different operation methods. Results： Patients all successfully completed radical surgery. The lymph nodes biopsies showed that 25 cases were with lymph node metastasis, and the rate was 41.67%（25/60）. And 13 patients had complications, including 4cases of anastomotic fistula, 4 cases of gastric emptying disorder, and 5 cases of pulmonary complications. Among them through right thoracolaparotomy and cervical approach surgery（3 incisions） showed the highest incidence rate which was 41.25%, compared with the other groups, there were significant differences（P 0.05）. Conclusion： Thoracic segment esophageal surgery should vary from person to person, the right choice to improve tumor resection rate, and reduce tumor recurrence, and different operation method of individual selection is effective to reduce the postoperative complications and improve the quality of survival.

关 键 词：食管癌 手术治疗 淋巴结清扫 

分 类 号：R735.1[医药卫生—肿瘤]