经右胸入路与左胸入路手术在胸中段食管癌患者中的应用效果比较  

Comparison of application effect of left thoracic approach and right thoracic approach in patients with middle thoracic esophageal carcinoma

作　　者：陈东辉 孙济生 CHEN Donghui;SUN Jisheng(Department of Thoracic Surgery,Feicheng Hospital of Yiyang Healthy Group,Shandong Province,Tai′an271608,China)

机构地区：[1]山东颐养健康集团肥城医院胸外科,山东泰安271608

出　　处：《中国当代医药》2023年第3期87-90,共4页China Modern Medicine

摘　　要：目的比较经右胸和经左胸入路在胸中段食管癌患者中的应用效果。方法选取2017年6月至2019年6月山东颐养健康集团肥城医院胸外科收治的40例胸中段食管癌患者进行回顾性分析,根据不同手术入路分为经左胸入路组(20例)和经右胸入路组(20例)。比较分析两组患者的手术时间、术中出血量、淋巴结清扫数目、纵隔淋巴结清扫数目、腹腔淋巴结清扫数目、胸腔引流量;比较两组患者的术后并发症总发生率;比较两组患者的术后病理情况。结果经右胸入路组患者的手术时间长于经左胸入路组,淋巴结清扫数目、纵膈淋巴结清扫数目多于经左胸入路组,差异有统计学意义(P<0.05)。两组患者的术中出血量、胸腔引流量、腹腔淋巴结清扫数目、并发症总发生率、术后病理(肿瘤长度、T、N、N转移区域)比较,差异无统计学意义(P>0.05)。结论经右胸入路清扫淋巴结更彻底,可以成为食管癌手术的优选路径。Objective To compare the application effect of left thoracic approach and right thoracic approach esophagectomy in the treatment of middle thoracic esophageal carcinoma.Methods A total of 40 middle thoracic esophageal carcinoma patients admitted to Department of Thoracic Surgery of Feicheng Hospital of Yiyang Healthy Group,Shandong Province from June 2017 to June 2019 were retrospectively studied.According to the different surgical approaches,the patients were divided into left transthoracic approach group(20 cases)and right transthoracic approach group(20 cases).The operation time,intraoperative blood loss,the number of lymph nodes dissected,the number of mediastinal lymph nodes dissected,the number of abdominal lymph nodes dissected,and the thoracic drainage volume of the two groups were compared and analyzed.The total incidence of postoperative complications was compared between the two groups.The postoperative pathological conditions of the two groups were compared.Results The operation time of patients in the right transthoracic approach group was longer than that in the left transthoracic approach group,and the number of lymph node dissection and mediastinal lymph node dissection in the right transthoracic approach group were higher than those in the left in the right transthoracic approach group,with statistically significant differences(P<0.05).There were no significant differences in intraoperative blood loss,thoracic drainage volume,number of abdominal lymph nodes dissection,total complication rate,postoperative pathology(tumor length,T,N,N metastasis area)between the two groups(P>0.05).Conclusion The right transthoracic approach is more thorough in lymph node dissection,and it can be the preferred approach for esophageal cancer surgery.

关 键 词：食管癌 食管切除术 右胸入路 左胸入路 

分 类 号：R735[医药卫生—肿瘤]