食管癌喉返神经旁淋巴结清扫的价值及相关并发症  

The value and related complications of lymph node dissection along bilateral recurrent laryngeal nerves in esophageal cancer patients

作　　者：袁立功 毛友生 Yuan Ligong;Mao Yousheng(Department of Thoracic Surgery,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100021,China)

机构地区：[1]国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院胸外科,北京100021

出　　处：《中华肿瘤杂志》2022年第7期712-716,共5页Chinese Journal of Oncology

摘　　要：食管癌是消化道高发恶性肿瘤之一,淋巴结转移是食管癌转移的主要方式,淋巴结转移的数量是食管癌分期的重要依据,且对患者预后及对术后治疗方式的选择有重要影响。喉返神经旁淋巴结是胸段食管癌转移率最高的淋巴结,是食管癌术中淋巴结清扫的重点。喉返神经旁淋巴结清扫降低食管癌术后局部复发率,且提高患者术后生存率和分期准确性,但同时也带来了术后喉返神经损伤及肺部并发症和营养不良等风险。因此,食管癌术中清扫双侧喉返神经旁淋巴结的同时应注意双侧喉返神经功能和结构的保护,尽量避免因损伤喉返神经带来的并发症对预后和生活质量的影响。Esophageal cancer is one of the most common malignant tumors of digestive tract,lymph node metastasis is a frequently encountered metastasis in the esophageal cancer patients.The number of lymph node metastasis is reported as an important prognostic factor,and it also affects the choice of postoperative treatments in the esophageal cancer.It was reported that the recurrent laryngeal nerve lymph nodes are the most common sites of nodal metastasis and need to be completely dissected during the esophagectomy for thoracic esophageal cancers.Dissection of the lymph nodes along bilateral recurrent laryngeal nerves not only improves the accuracy of staging,but also improves postoperative survival of esophageal cancer patients due to reducing the local recurrence.However,it also brings problems such as injury of laryngeal recurrent nerves,and increases postoperative complications such as pulmonary complications and malnutrition due to aspiration and coughing.Therefore,it is necessary to preserve the structure and function of bilateral recurrent laryngeal nerves during esophagectomy through careful manipulations,and minimize the impact of complications in prognosis and quality of life from injury to the recurrent laryngeal nerve.

关 键 词：食管肿瘤 喉返神经旁淋巴结 喉返神经麻痹 肺部并发症 

分 类 号：R735.1[医药卫生—肿瘤]