食管癌切除不同入路二野淋巴结清扫术疗效比较

目的:探讨临床不同入路及二野淋巴结清扫术在食管癌切除中的应用。方法:选取2007年1月-2008年12月128例食管癌，分为Ivor-Lewis手术组（68例）和左胸手术组（60例），对比两组胸腔、腹部淋巴结清扫数量、术后并发症及1、3、5年存活率。结果:左胸组上纵隔淋巴结转移和右侧气管旁三角淋巴结转移率均明显低于Ivor-Lewis组,有统计学意义（P<0.05）；下纵隔和腹部区淋巴结转移率及并发症两组比较无明显差异（P>0.05）；术后1、3年生存率两组无明显差异（P>0.05），5年生存率Ivor-Lewis组明显高于左胸组（P<0.05）。结论:Ivor-Lewis术式二野清扫的转移淋巴结及术后5年存活率均优于左胸入路术式。

Comparison of Ivor-Lewis operation and left thoracotomy with two fields lymphadenec-tomy for esophageal carcinoma

Objective：To investigate the clinical effectiveness of Ivor-Lewis operation and left thoracotomy with two fields lymph node dissection for esophageal carcinoma. Methods：Total 128 cases of esophageal cancer were divid-ed into Ivor-Lewis group（68 cases）and left thoracotomy group（60 cases）. The metastatic lymph node dissected from the thoracic and abdominal cavities,postoperative complications and 1,3,5-year survival rates were compara-tively analyzed. Results：The rate of superior mediastinal and right paratracheal lymph node metastasis was significantly lower than those in Ivor-Lewis group（P〈0. 05）,but inferior mediastinal and abdominal（P〉0. 05）. Also the postoperative complication and 1,3-year survival rates were similar between the two groups（P〉0. 05）. Interesting-ly,the 5-year survival rate of Ivor-Lewis group was significantly higher than that of left chest group（P〈0. 05）. Conclusion：Both metastatic lymph nodes dissected from the two fields and 5-year survival rate by Ivor-Lewis approach was better than the left thoracotomy.