改良喉返神经淋巴结清扫术的疗效  

The efficacy of modified recurrent laryngeal nerve lymph node dissection

作　　者：朱盼盼 李少欣 ZHU Panpan;LI Shaoxin(Department of Oncology,Weinan Central Hospital,Weinan 714000,China;Department of Thoracic Surgery,Weinan Central Hospital,Weinan 714000,China)

机构地区：[1]渭南市中心医院肿瘤外科,陕西渭南714000 [2]渭南市中心医院胸外科,陕西渭南714000

出　　处：《中国肿瘤外科杂志》2024年第4期340-343,348,共5页Chinese Journal of Surgical Oncology

基　　金：渭南市科技计划项目(编号:2023ZDYFJH-246)

摘　　要：目的探讨改良喉返神经淋巴结清扫术治疗食管鳞状细胞癌的疗效。方法回顾性分析于2019年1月至2021年2月在渭南市中心医院行胸腔镜食管鳞状细胞癌手术治疗的110例患者的临床资料,其中63例患者行改良喉返神经淋巴结清扫术纳入改良组,47例患者行传统喉返神经淋巴结清扫术纳入对照组。比较两组患者手术相关指标、淋巴结清扫情况、并发症发生情况、复发情况及预后结局。结果两组患者手术时间、术中出血量、引流管留置时间、住院时间比较,差异无统计学意义(P>0.05)。改良组喉返神经淋巴结清扫数目、3年生存率及生存时间高于对照组,总并发症发生率、复发率低于对照组(P<0.05)。术后6个月,两组患者吞咽困难、进食、反流、疼痛、吞咽口水、进食梗阻、口干、食欲减退、咳嗽评分均较术前降低,且改良组吞咽困难、进食评分高于对照组(P<0.05)。结论行改良喉返神经淋巴结清扫术有助于提高胸腔镜食管鳞状细胞癌手术患者生存质量、延长生存时间、降低复发率及并发症发生率,患者预后较好。Objective To explore the efficacy of modified recurrent laryngeal nerve lymph node dissection in the treatment of esophageal squamous cell carcinoma.Methods The clinical data of 110 patients admitted to Weinan Central Hospital receiving thoracoscopic surgery for esophageal squamous cell carcinoma from January 2019 to February 2021 were retrospectively analyzed.Among them,63 patients underwent modified recurrent nerve lymph node dissection and 47 patients underwent traditional recurrent nerve lymph node dissection and were included in the improved group and the control group,respectively.The surgical indexes,lymph node dissection,complications,recurrence and prognosis were compared between the two groups.Results There were no significant differences in operation time,intraoperative blood loss,drainage tube indwelling time and hospital stay between the two groups(P>0.05).The number of recurrent laryngeal nerve lymph node dissection,3⁃year survival rate and survival time in the improved group were significantly higher than those in the control group,and the total complication rate and recurrence rate were significantly lower than those in the control group(P<0.05).Six months after surgery,scores for dysphagia,eating,reflux,pain,swallowing saliva,eating obstruction,dry mouth,appetite loss,and coughing in both groups were significantly lower than before surgery.Additionally,the improved group had higher scores for dysphagia and eating compared to the control group(P<0.05).Conclusions Improved recurrent laryngeal lymph node dissection helps improve the quality of life,prolong the survival time,reduce the recurrence rate and complication rate of patients undergoing thoracoscopic esophageal squamous cell carcinoma surgery,leading to better patients prognosis.

关 键 词：单中心回顾性分析 喉返神经淋巴结清扫术 胸腔镜手术 食管鳞状细胞癌 预后 

分 类 号：R735.1[医药卫生—肿瘤]