经右胸三切口与左胸两切口入路对胸中段食管癌患者手术效果、淋巴结转移和远期预后的影响  

The Effect of Three Right Thoracotomy and Two Left Thoracotomy Approach on the Operative Effect, Lymph Node Metastasis and Long-term Prognosis of Patients with Middle Thoracic Esophageal Cancer

作　　者：冯容 林志伟 罗月湘 冯敏[4] 邓红 FENG Rong;LIN Zhi-wei;LUO Yue-xiang;FENG Min;DENG Hong(Department of General Surgery,The Third Affiliated Hospital of Hunan University of Traditional Chinese Medicine/Hunan Provincial Hospital of Traditional Chinese Medicine,Zhuzhou,Hunan,412000,China;Second Department of Thoracic Surgery,Hunan Provincial Tumor Hospital,Changsha,Hunan,410000,China;Reproductive Medicine Centre,Changsha Maternal and Child Health Hospital,Changsha,Hunan,410007,China;Department of Oncology,The Third Affiliated Hospital of Hunan University of Traditional Chinese Medicine(Hunan Provincial Hospital of Traditional Chinese Medicine),Zhuzhou,Hunan,412000,China;Children's Medical Center,Hunan Provincial People's Hospital,Changsha,Hunan,410005,China)

机构地区：[1]湖南中医药大学第三附属医院/湖南省直中医医院普外科,湖南株洲412000 [2]湖南省肿瘤医院胸外二科,湖南长沙410000 [3]长沙市妇幼保健院生殖医学中心,湖南长沙410007 [4]湖南中医药大学第三附属医院/湖南省直中医医院肿瘤科,湖南株洲412000 [5]湖南省人民医院儿童医学中心,湖南长沙410005

出　　处：《现代生物医学进展》2021年第14期2717-2720,共4页Progress in Modern Biomedicine

基　　金：湖南省教育厅科学研究项目(16C1256)。

摘　　要：目的:探讨经右胸三切口与左胸两切口入路对胸中段食管癌患者手术效果、淋巴结转移和远期预后的影响。方法:回顾性分析2013年2月2015年3月期间我院收治的胸中段食管癌患者90例的临床资料,根据入路方式的不同将患者分为A组(n=44,左胸两切口入路)和B组(n=46,右胸三切口入路),比较两组患者手术效果、淋巴结转移、并发症和远期预后。结果:B组手术时间、住院时间、术后留置胸管时间均长于A组,术中出血量多于A组(P<0.05)。B组淋巴结清扫数多于A组,淋巴结总转移率则低于A组(P<0.05)。两组1年生存率比较差异无统计学意义(P>0.05);B组3年生存率、5年生存率均高于A组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:与左胸两切口入路相比,胸中段食管癌患者选用经右胸三切口入路,虽术中创伤大,术后恢复略慢,但该入路方式在淋巴结转移率、生存率方面有明显改善,且不增加并发症发生率。Objective: To investigate the effect of three right thoracotomy and two left thoracotomy approach on the operative effect, lymph node metastasis and long-term prognosis of patients with middle thoracic esophageal cancer. Methods: The clinical data of90 patients with middle thoracic esophageal cancer who were admitted to our hospital from February 2013 to March 2015 were retrospectively selected. According to the different approaches, the patients were divided into two groups: group A(n=44, two left thoracotomy approach) and group B(n=46, three right thoracotomy approach). The operative effect, lymph node metastasis,complications and long-term prognosis of the two groups were compared. Results: The operation time, hospitalization time and postoperative indwelling time of thoracic duct in group B were longer than those in group A, and the intraoperative blood volume was more than that in group A(P<0.05). The number of lymph nodes dissected in group B was more than that in group A, and the total rate of lymph nodes metastasis was lower than that in group A(P<0.05). There was no significant difference in 1-year survival rate between the two groups(P>0.05). The 3-year and 5-year survival rates in group B were higher than those in group A(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05). Conclusion: Compared with the two left thoracotomy approach, the three right thoracotomy approach is used in the patients with esophageal cancer in the middle part of chest,which has great trauma during operation, and slow recovery after operation. However, the approach way can improve the lymph node metastasis rate and survival rate, and it did not increase the incidence of complications.

关 键 词：右胸三切口 左胸两切口 入路 胸中段食管癌 手术效果 淋巴结转移 远期预后 

分 类 号：R735.1[医药卫生—肿瘤]