两种剖胸术治疗食管癌的比较与分析

目的探讨治疗食管癌的理想手术切口。方法回顾性收集在我科采用腋下横切口治疗食管癌患者212例（TT组）,并与同期采用传统后外侧切口治疗食管癌317例患者（PLT组）的临床资料进行对比分析。结果 TT组高龄患者比例高,术前有伴发病患者居多,术后1个月肩部功能恢复及3年生存率比例高（P〈0.05）,PLT组肿瘤浸润深、病理分期晚（P〈0.01）,术后1个月切口慢性疼痛比例高（P〈0.05）。两组手术时间、根治性手术比例、术后并发症及术后1年生存率无统计学意义（P〉0.05）。结论腋下横切口治疗食管癌创伤小,术后恢复快,可作为食管癌手术常规和首选的探查切口。必要时可随即中转后外侧切口完成根治性手术。

The comparison and the analysis of two kinds of chest operation techniques for treating esophagus cancer

Objective To investigate the ideal surgical incision in treating esophagus cancer. Methods Clinical data of 212 esophagus cancer patient treated with operation by armpit horizontal incision （ the TT group） were collected retrospectively and compared with the clinical data of 317 esophagus cancer patients treated with of operation by traditional flank incision （ the PLT group） . Results In TT group,the proportion of patients of advanced age was higher,more patients had complications before operation,more patients had shoulder function restored at one month after operation and 3 year survival rate was higher （ P 0. 05） . In PLT group,the tumor infiltration was deep,the pathology stage was relatively late,the proportion of patients with chronic ache at incision site one month after operation was higher （ P 0. 01） . The operation time,proportion of radical operation,the complications after operation and 1-year survival rate were not statistically different between the two groups （ P 0. 05） . Conclusion Treatment of esophageal cancer with armpit horizontal incision had smaller wound and faster postoperative recovery,and can be used as conven-tional esophagus cancer operation and the first choice of exploration incision. If necessary,it can be changed to the flank incision to complete the radical surgery.