43例右开胸三切口治疗胸上、中段食管癌疗效观察

目的探讨右开胸三切口治疗胸上、中段食管癌的并发症及生存率,为临床提供参考。方法采用前瞻性研究的方法,分析肇庆市第一人民医院自2006年7月至2009年7月收治的86例上中段食管癌患者,按照配对设计将患者分为试验组和对照组,试验组采用左颈、右胸、腹正中三切口的手术方法,对照组采用左颈、左胸两切口的方法,比较两组的疗效。结果试验组和对照组手术时间、淋巴结清扫数、吻合口瘘和喉返神经损伤情况比较,差异有统计学意义(P<0.05);两组胸腔积液引流量、术中出血量、住院时间及乳糜胸比较,差异无统计学意义(P>0.05)。试验组和对照组存活率比较,3年存活率试验组高于对照组,差异有统计学意义(P<0.05)。结论对于有手术指征的胸上、中段食管癌患者,右开胸三切口有利于提高肿瘤的根治率,有效地提高患者的生存率,值得临床推广。

The Curative Effects Observation on 43 Cases of Right-side Three-incision Thoracotomy Treating Upper or Mid-thoracic Esophagus Cancer

Objective To explore the complications and survival rate of right-side threc-incision surgery for treatment of the upper or mid-thoracic esophagus, to provide reference for the clinical practice. Methods 86 cases with upper or mid-thoracic esophagus cancer in the First People＇s Hospital of Zhaoqing from July 2006 to July 2009 were anaylzyed by the prospective study method,which were divided into the trial group and control group by the matching design, the trial group was given the three-incision surgical approach from the left neck, right chest and middle abdomen;the control group was given the two-incision from the left neck and left chest;the therapeutic effect of the two groups was compared. Results The operation of the trial group and control group were statistically significantly different（ P 〈 0.05 ）in operation time,the number of lymph node dissection, anastomotic leak and recurrent laryngeal nerve injury situation;there were no statistical difference in pleural effusion cited traffic, blood loss, hospital stay and chylothorax （ P 〉 0.05 ）. The 3 years of survival rate of the trial group was higher than the control group with statistically significant difference（ P 〈 0.05 ）. Conclusion Right-side three-incision surgery for treatment of the upper or mid-thoracic esophagus with the indications is helpful to improve the cure rate and survival rate, thus is worth of clinical promotion.