胸段食管鳞癌左右胸入路手术方式的近期效果比较  

Comparison of short-term effect of left and right transthoracic approach surgery treating thoracic esophageal squamous cell carcinoma

作　　者：刘迪填[1] 陈少斌[1] 李华[1] 翁鸿锐[1] 杨捷生[1] 杨卫平[1] 王耿[1] 黄楚坚[1] 陈卓宏[2] 陈于平[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院胸外科,515031 [2] 广州市胸科医院外科

出　　处：《中国医药》2015年第4期546-548,共3页China Medicine

基　　金：广东省汕头市重点科技计划（2011-46-9）

摘　　要：目的 比较左右胸入路胸段食管鳞癌二野淋巴结清扫的近期效果.方法 收集2010年5月至2011年12月汕头大学医学院附属肿瘤医院手术治疗的胸段食管鳞癌患者288例,根据手术方式分为左胸组（136例）和右胸组（152例）.对2组的淋巴结清扫情况和术后并发症等进行回顾性分析.结果 右胸组平均手术时间为（253±38） min,明显长于左胸组（183±27） min,差异有统计学意义（P＜0.01）.左胸组术后肺部感染发生率低于右胸组,差异有统计学意义[0.7％（1/136）比5.3％（8/152）,P＜0.05].术后病理发现淋巴结转移发生率左胸组45.6％（62/136）,右胸组51.3％（78/152）,2组比较差异无统计学意义（P＞0.05）.胸部淋巴结转移发生率左胸组明显低于右胸组,2组间比较差异有统计学意义[30.2％（41/136）比43.4％（66/152）,P=0.016],但腹部淋巴结转移发生率2组间差异无统计学意义[31.6％（43/136）比27.6％（42/152）,P＞0.05].结论 右胸入路较左胸入路食管癌切除术明显增加手术并发症.Objective To compare the short-term effect of left and right transthoracic approach surgery treating thoracic esophageal squamous ceil carcinoma patients. Methods Data of 288 patients with thoracic esophagus squamous cell carcinoma who underwent surgical resection in Cancer Hospital of Shantou University Medical College from May 2010 to December 2011 , including 136 through left thoraeotomy （left thoraeotomy group） and 152 through right thoracotomy （right thoraeotomy group） , were retrospec- tively analyzed. The lymphadenectomy effect and postoperative complications were analyzed and compared between the two groups. Results The average operation time in right thoracotomy group was significantly longer than that in left thoracotomy group [ （253 ＋38）rain vs （183 -＋27） minl （P〈0.01）. The inci- dence of lung infection in right thoracotomy group was significantly higher than that in left thoracotomy group [5.3% （8/152） vs 0.7% （ 1/136）, P 〈0.05]. Sixty-two patients （45.6%） in left thoraeotomy group were pathologically confirmed with lymph node metastasis, showing no significant difference compared with that in right thoracotomy group [ 78 patients （51.3% ） ] （P = 0.332）. Compared with right thoraeotomy group,the metastasis rate of thoraciclymph node in left thoracotomy group was statistically lower [30.2% （41/136） vs 43.4% （66/152）, P =0.016], but the metastasis rateofabdominal lymph node was not statistically different [ 31.6% （43/136 ） vs 27.6% （42/152 ）, P =0.459]. Conclusion The incidence of major postoperative complications in right transthoracic approach surgery is higher than that in left transthoracic approach surgery treating thoracic esophageal squamous cell carclnoma.

关 键 词：食管鳞癌 外科手术 淋巴结清扫 并发症 

分 类 号：R735.1[医药卫生—肿瘤]