两种径路治疗胸中段食管癌的手术评价

目的:比较左胸和右胸入路治疗胸中段食管癌的疗效差异。方法:选取我院自2002年1月至2007年12月收治的34例行左胸入路治疗(左胸组)和42例行右胸入路治疗(右胸组)患者,回顾性分析两种径路的手术并发症、淋巴结清扫情况及生存率。结果:左胸组清扫淋巴结12.1±5.3枚,右胸组清扫淋巴结16.9±6.4枚(P<0.05);左胸组3年复发率高于右胸组(P<0.05),3年总生存率低于右胸组(P<0.05);左胸组并发症总发生率为23.53%,低于右胸组的47.62%(P<0.05);左胸组手术时间和术中出血量分别为225.5±38.9 min和459.4±50.2mL,优于右胸组的288.3±49.8min和519.1±69.2 mL(P<0.05)。结论:经右胸入路操作复杂,并发症较多,但可减少淋巴结复发,并提高无病生存率。

Comparing the Therapeutic Effect of Two Kinds of Transthoracic Operative Approaches for Patients with Middle Thoracic Esophageal Cancer

Objective: To compare the therapeutic effect of two kinds of transthoracic operative approaches for patients with middle thoracic esophageal cancer.Method: Survival analysis was used to investigate operation complications,lymph node dissection and survival rate of 34 patients undergoing left thoracic approach(left approach group) and 42 patients undergoing right thoracic approach(right approach group) from January 2002 to December 2007.Result: The number of lymph nodes resected in right approach group was more than in left approach group(16.9±6.4 vs 12.1±5.3,P<0.05);3 years recurrence rate in left approach group was higher than that in right approach group(P< 0.05),while the 3 years overall survival rate in left approach group was lower than that in the right approach group(P <0.05);operation time and blood loss in left approach were 225.5 ± 38.9 and 459.4 min ±50.2 mL,which were better than those in right approach group(P<0.05).Conclusion: Right transthoracic resection increases the incidence of complications,but it can reduce lymphatic recurrence rate and increase disease-free survival rate.