右胸单切口与双切口术式在胸中上段食管癌治疗中的临床应用分析

目的探讨右胸单切口术式在胸中上段食管癌治疗中的应用价值。方法选择2008年10月至2013年4月收治的食管癌患者58例,将30例胸中上段食管癌行右单切口术式的患者纳入试验组,另28例胸中上段食管癌同期行右胸及上腹双切口术式的患者纳入对照组。比较两组患者手术时间、术中出血量、淋巴结清扫个数、术后并发症以及术后生存情况。结果试验组手术时间明显短于对照组,差异有统计学意义(P0.01);其他指标比较差异无统计学意义(P0.05),但由于对照组双切口范围较大,所以淋巴结清扫个数要多于试验组。两组患者1年生存率均为100%;3年生存率试验组84.62%,对照组84.00%;5年生存率试验组46.15%,对照组48.00%,3年及5年生存率差异均无统计学意义(P0.05)。结论右胸单切口术式切口少,创伤小,手术时间短,值得临床开展。

Analysis of the clinical application of right thoracal single and double incision in the treatment of mid-thoracic and upper-thoracic e-sophageal cancer

Objective To investigate the use of right thoracic single incision in the treatment of mid-thoracic and upper-thoracic esoph-ageal cancer. Methods 58 patients with esophageal cancer from October 2008 to April 2013 were selected. 30 patients of mid-thoracic and up-per-thoracic esophageal cancer recieved right thoracic single incision into test group,28 cases of mid-thoracic and upper-thoracic esophageal cancer recieved right thoracic and upper abdominal double incision into control group. The operation time,intraoperative blood loss,number of re-sected lymph nodes,postoperative complications and postoperative survival were compared between two groups. Results Operation time in the test group was shorter than that of control group. There was significant difference（ P 〈0. 01）. There was no significant difference in other indexes（ P〉0. 05）. But two incision range in the control group was large,so the number of resected lymph nodes was much than taht in the test group. 1 years survival rate both in two groups was 100%;3 years survival rate in the test group was 84. 62%,the control group was 84%;5 years survival rate in the test group was 46. 15%,control group was 48%. 3-year and 5-year survival rates were not significantly different（ P 〉0. 05）. Con-clusion Right thoracic single incision having small incision,little trauma,short operation time. It is worth of clinical development.