不同手术径路治疗中段食管癌的近期临床疗效观察

目的探讨经右胸及左胸治疗中段食管癌的临床疗效,为其治疗寻找有效的手术径路。方法回顾分析43例经右胸入路手术(观察组)和40例经左胸入路手术(对照组)治疗的食管癌患者的临床资料。结果两组患者肿瘤切除率相似,差异无统计学意义(P>0.05)。观察组患者手术时间、术中出血量、平均淋巴结清扫个数及淋巴转移度、术后并发症发生率均高于对照组,差异有统计学意义(P<0.05)。观察组患者术后3年复发率低于对照组,而生存率高于对照组,差异有统计学意义(P<0.05)。结论经右胸入路手术治疗食管癌操作相对复杂,并发症较多,手术创伤大,但是手术疗效好,术后复发率低,生存率高,值得临床推广应用。

Observation on the Short-term Clinical Therapeutic Effects of Different Surgical Approaches on Middle Segment Esophageal Carcinoma

Objective To investigate the clinical therapeutic effects of operation via right thoracotomy and operation via left thora cotomy on middle segment esophageal carcinoma and to look for effective surgical approaches for it.M ethods The clinical data on 43 esophageal carcinoma patients who underwent operations via right thoracotomies（observation group） and 40 esophageal carcino ma patients who underwent operations via left thoracotomies（control group） was retrospectively analyzed.Results The tumor abla tion ratios of the two groups were similar and the difference was statistically insignificant（P〈0.05）.The operative time,intraoperative hemorrhage volume,average scavenged lymph node number,lymphatic metastasis degree and the incidence of postoperative complications were all higher than those of the control group,and the differences were statistically significant（P〈0.05）.In 3 years after the operation,the relapse rate of the observation group was lower than that of the control group,while the survival rate of the observation group was higher than the control group,and the differences were statistically significant（P〈0.05）.C onclusion Operation via right thoracotomy in treatment of esophageal carcinoma is relatively complex and with more complications and greater op eration wound,but has better surgical therapeutic effects,lower postoperative relapse rate and higher survival rate,and is conse quently worthy of clinical application.