新辅助化疗联合胸腹腔镜手术治疗Ⅲa期和Ⅲb期食管鳞癌的疗效观察  

Observation of curative effect of neoadjuvant chemotherapy combined with thoracic laparoscopic surgery in treating esophageal squamous cell carcinoma at stageⅢa andⅢb

作　　者：王晨[1] 张沛刚[1] 马秉灵[1] WANG Chen;ZHANG Pei-gang;MA Bingling(Department of cardiothoracic surgery,Fenyang Hospital Affiliated to Shanxi Medical University,Luliang,Shanxi 032200,China;不详)

机构地区：[1]山西医科大学附属汾阳医院胸心外科,山西吕梁032200

出　　处：《中国医学装备》2022年第5期129-132,共4页China Medical Equipment

基　　金：山西省卫生计生委科研课题(2015145)“新辅助化疗联合胸腹腔镜手术治疗Ⅲa、Ⅲb期食管鳞癌的疗效观察”。

摘　　要：目的:探讨新辅助化疗联合胸腹腔镜治疗在肿瘤、淋巴结及远处转移(TNM)分期中Ⅲa期和Ⅲb期食管鳞癌的临床疗效。方法:选取医院收治的60例Ⅲa期和Ⅲb期食管鳞癌患者,按照治疗方式的不同分为观察组和对照组,每组30例。观察组采用新辅助化疗联合胸腹腔镜手术治疗,对照组采用直接手术治疗,比较两组治疗疗效、围术期相关指标,以及术后1年和3年生存率。结果:观察组治疗后,完全缓解(CR)4例,部分缓解(PR)17例,稳定(SD)8例,进展(PD)1例,治疗有效率为70%。观察组手术时间和胸管留置时间与对照组比较差异均无统计学意义;观察组术中出血量和住院时间均低于对照组,淋巴结清扫数目高于对照组,差异均有统计学意义(t=-7.138,t=-8.442,t=6.929;P<0.05)。观察组手术切除率和手术根治率高于对照组,淋巴结转移率低于对照组,差异均有统计学意义(x^(2)=4.267,x^(2)=4.267,x^(2)=3.115;P<0.05)。观察组术后肺部感染发生率优于对照组,差异有统计学意义(x^(2)=4.022,P<0.05)。观察组术后1年复发率为10.00%,术后1年转移率为16.67%,1年、3年生存率分别为86.67%和50.00%;对照组术后1年复发率为36.67%,术后1年转移率为40.00%,1年、3年生存率分别为73.33%和26.67%;两组间差异均有统计学意义(x^(2)=5.963,x^(2)=4.022,x^(2)=9.320,x^(2)=4.329;P<0.05)。结论:新辅助化疗联合胸腹腔镜手术治疗Ⅲa期和Ⅲb期食管鳞癌,临床疗效肯定。Objective:To investigate the clinically curative effect of neoadjuvant chemotherapy combined with thoracic laparoscopic surgery in treating esophageal squamous cell carcinoma at stageⅢa andⅢb in the staging of tumor,lymph node and tumor node metastasis(TNM).Methods:60 patients with esophageal squamous cell carcinoma at stageⅢA andⅢb who admitted to hospital were selected,and they were divided into observation group and control group,with 30 cases in each group.Observation group adopted neoadjuvant chemotherapy combined with thoracic laparoscopic surgery and control group adopted directly surgery.The curative effect,the relative indicators of perioperative period as well as the survival rates 1 year and 3 years after treatment between two groups were compared.Results:After treatment,4 cases were complete remission(CR),and 17 cases were partial remission(PR),and 8 cases were stable disease(SD),and progressive disease(PD),and the response rate(RR)of treatment was 70%in observation group.There were no significant differences in operation time and chest tube indwelling time between observation group and control group.The amount of intraoperative bleeding and hospital stay in observation group were significantly lower than those in control group,and the dissection number of lymph node in observation group was significantly higher than that in control group(t=-7.138,t=-8.442,t=6.929,P<0.05).The resection rate and radical cure rate of observation group were significantly higher than those of control group,and the lymph node metastasis rate of observation group was significantly lower than that of control group(x^(2)=4.267,x^(2)=4.267,x^(2)=3.115,P<0.05).The incidence rate of postoperative pulmonary infection of observation group was significantly higher than that of control group(x^(2)=4.022,P<0.05).In observation group,the 1-year recurrence rate was 10.00%,and the 1-year postoperative metastasis rate was 16.67%,and the 1-year and 3-year survival rates were 86.67%and 50.00%respectively.In control group,the above

关 键 词：食管鳞癌 新辅助化疗 胸腹腔镜 疗效 

分 类 号：R735.1[医药卫生—肿瘤]