220例右胸腹部二切口治疗胸段食管癌的疗效分析

目的：分析总结经右胸、腹部二切口手术治疗胸段食管癌的疗效与体会。方法：回顾分析1998年1月～2000年12月经腹部正中切口游离胃，右胸后外侧切口切除食管肿瘤，食管胃胸顶机械吻合，并行二野淋巴结扩大清扫术的220例胸段食管癌患者的临床资料，随访1、3、5年的生存率。结果：220例切除率96.4％（212／220）。并发症7.3％（16／220）。无围手术期死亡，术后1、3、5年的生存率Ⅰ期为100．0％、86．9％、82．6％，Ⅱa期为87.3％、81．8％、56.4％．Ⅱb期为81．1％、67.4％、44．2％，Ⅲ期为57.4％、25．5％、17．0％，结论：右胸、腹部二切口手术治疗胸段食管癌是一种安全、有效的手术方法．术后结合放化疗可提高患者的远期生存率。

The Effect of Right Thoracotomy and Ventrotomy on Patients with Thoracic Segment Esophageal Carcinoma (A Report of 220 Cases)

Objective: To evaluate the clinical effects of surgical treatment by right posterior thoracotomy and laparotomy for patients with thoracic esophageal carcinoma. Methods: From January 1998 to December 2000, 220 patients with esophageal carcinoma of the thoracic segment underwent a radical esophagectomy and a two-incision lymphadenectomy by right posterior thoracotomy and upper-middle laparotomy, with postoperative radiochemotherapy. Results: The rate of surgical resection was 96.4% with a complication rate of 7.3%. The 1, 3 and 5-year survival rates were 100%, 86.9% and 82.6% in Stage I, 87.3%, 81.8% and 56.4% in Stage IIa, 81.1%, 67.4% and 44.2% in Stage IIb and 57.4%, 25.5% and 17.0% in Stage III, respectively. Conclusion: Esophagectomy by right thoracotomy and laparotomy is a safe and effective procedure. The long-term survival rate can be improved if proper postoperative radiochemotherapy is conducted.