不同吻合方式对行右胸入路根治术中下段食管癌恢复的影响比较  

Comparison of the Effects of Different Anastomosis Methods on the Recovery of Patients with Lower Esophageal Cancer Undergoing Right Thoracic Approach Radical Surgery

作　　者：王启昕 朱正帅 杨子林 王旸[1] WANG Qi-xin;ZHU Zheng-shuai;YANG Zi-lin;WANG Yang(Thoracic Surgery Department,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)

机构地区：[1]南阳市中心医院胸外科,河南南阳473000

出　　处：《罕少疾病杂志》2025年第2期87-88,共2页Journal of Rare and Uncommon Diseases

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20210978)。

摘　　要：目的 比较不同吻合方式对行右胸入路根治术中下段食管癌患者恢复的影响。方法 回顾性2021年9月至2023年9月医院85例行右胸入路根治术治疗的中下段食管癌患者资料,根据吻合方式,将其分为对照组(食管胃胸腔内吻合,42例)和观察组(食管胃颈部吻合,43例)。比较两组围术期指标、食管切端癌残留率、术后并发症、生活质量[癌症患者生活质量测定量表(QLQ-C30)]及生存率。结果 与对照组相比,观察组食管切除更长,置管时间、住院时间更短(P<0.05);观察组切端癌残留率更低(P<0.05);观察组术后3年生存率更高(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05);术后,两组QLQ-C30评分均较术前升高,且观察组更高(P<0.05)。结论 相较食管胃胸腔内吻合,右胸入路根治术中采用食管胃颈部吻合可缩短中下段食管癌患者术后置管时间、住院时间,减少切端癌残留,提高生活质量及远期生存率。Objective To compare the effects of different anastomosis methods on the recovery of patients with lower esophageal cancer undergoing right thoracic approach radical surgery.Methods A retrospective study was conducted on 85 patients with middle and lower esophageal cancer who underwent right thoracic radical surgery in the hospital from September 2021 to September 2023.They were divided into a control group(42 cases)and an observation group(43 cases)according to the anastomosis method.Perioperative indicators,residual esophageal cancer rate,postoperative complications,quality of life(QLQ-C30),and survival rate were compared between two groups.Results Compared with the control group,the observation group had longer esophagectomy,shorter tube placement time,and shorter hospital stay(P<0.05).The residual rate of cut end cancer in the observation group was lower(P<0.05).The observation group had a higher 3-year postoperative survival rate(P<0.05).There was no statistical significant difference in the incidence of complications in both groups(P>0.05).After surgery,the QLQ-C30 scores of both groups increased compared to before surgery,and the observation group was higher(P<0.05).Conclusion Compared with esophagogastric thoracic anastomosis,using cervical esophagogastric anastomosis in right thoracic approach radical surgery can shorten the postoperative tube placement time and hospitalization time of patients with middle and lower esophageal cancer,reduce residual cancer at the cutting end,improve quality of life and long-term survival rate.

关 键 词：食管癌 右胸入路根治术 食管胃胸腔内吻合 食管胃颈部吻合 

分 类 号：R735.1[医药卫生—肿瘤]