腔镜微创食管癌根治术治疗SiewertⅠ型胃食管结合部鳞癌的短期疗效评估  

The Short-Term Efficacy of Three-Field Minimally Invasive Esophagectomy in the Treatment of Siewert Type I Esophago-gastric Junctional Squamous Carcinoma

作　　者：蔡磊[1] 李艳 肖书傲 刘书尚 刘震[1] 杨学文[1] 王文斌[1] 郎建勇 靳雁[1] 

机构地区：[1]第四军医大学西京消化病医院,陕西西安710032 [2]西北妇女儿童医院麻醉科,陕西西安710061 [3]第四军医大学西京医院心脏外科监护室,陕西西安710032

出　　处：《现代生物医学进展》2015年第36期7054-7057,7149,共5页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目（81300301）;第四军医大学优秀文职人员培养基金项目;第四军医大学西京医院2014年度助推计划

摘　　要：摘要目的：探讨腔镜微创食管癌根治术治疗SiewertⅠ型胃食管结合部鳞癌患者的短期临床疗效及安全性。方法：选取我科2009年1月1日至2012年3月1日收治的SeiwertⅠ型胃食管结合部鳞癌患者114例，并将其随机分为开胸食管切除术组（59例）和腔镜微创食管切除术组（55例），评估并比较两组的短期临床疗效及并发症的发生情况。结果：微创食管切除术组患者术后生存质量评分评分均显著高于开胸食管切除术组（P〈0．05），患者2年生存率为83．6％（46／55），高于开胸食管切除术组（47／59，79．7％）。此外，微创食管切除术组肺部并发症（9．09％VS28．81％）和声带麻痹（0％VS15．25％）的发生率均显著低于开胸食管切除术组（P〈0．05）。结论：腔镜微创食管癌根治术可显著提高SiewertⅠ型胃食管结合部鳞癌短期疗效。Objective： To evaluate the short-term efficacy and safety of three-field minimally invasive esophagectomy in the treatment of Siewert type I esophago-gastric junctional squamous carcinoma. Methods： From January 1, 2009, to March 1, 2012, 114 consecutive patients with Siewert type I esophagogastric junctional suamous carcinoma were involved in this retrospective study. Patients were randomly assigned by acomputer-generated randomization sequence to receive either three-incision open esophagectomy or minimally invasive esophagectomy. Details concerning short-term efficacy and complications were collected and analyzed. Results： Totally, 59 patients were involved in the open esophagectomy group and 55 patients were involved in the minimally invasive esophagectomy group. The incidence of pulmonary morbidity （9.09% versus 28.81%） and vocal cord paralysis （0% versus 15.25%） in the minimally invasive group were significantly lower than those in the open esophagectomy group （P〈0.05）. Furthermore, the postoperative quality of life in the minimally invasive esophagectomy group was better than that in the open esophagectomy group. The 2-year survival rate was 83.6% in the minimally invasive esophagectomy group （46 of 55 patients） and 79.7% in the open esophagectomy group （47 of 59 patients）, no significant difference was observed （P〉0.05）. Conclusions： Minimally invasive esophagectomy could significantly improve the short-term efficacy of patients with Siewert type I esophagogastric junctional suamous carcinoma.

关 键 词：腔镜微创食管癌根治术 Siewert Ⅰ型胃食管结合部鳞癌 短期疗效 安全性 

分 类 号：R735.1[医药卫生—肿瘤]