老年人食管癌的外科治疗

Surgical treatment for aged people with esophagus carcinoma

目的探讨颈、胸、腹三切口手术入路对老年食管癌患者的治疗。方法我院胸心外科老年食管癌根治手术患者231例,根据年龄是否≥70岁及所采用的不同手术入路分为3组Ⅰ组年龄<70岁,左胸后外侧切口71例;Ⅱ组年龄<70岁,三切口131例;Ⅲ组年龄≥70岁,三切口29例。结果Ⅰ组与Ⅱ组、Ⅲ组清扫的淋巴结数相比差异具有统计学意义(P<0.05);Ⅲ组并发症发生率较高(58.6%),但围手术期病死率(3.4%)与Ⅰ组(2.8%)相比差异无显著性;Ⅰ组、Ⅱ组与Ⅲ组术后并发症相比差异有统计学意义(P<0.05),术后1、3年生存率相比差异无统计学意义(P>0.05)。结论食管癌患者行三切口手术,可彻底清除各组区域淋巴结。对有适应证的老年食管癌患者可积极采取三切口手术治疗。

Objective To study the surgical treatment for aged people with esophagus carcinoma via neck,chest and abdomen approach. Methods 231 aged people with esophagus carcinoma were divided into three groups by different surgical approach and age. Group I （71 cases） ：left postlacterior thoracotomy and younger than 70 years. Group Ⅱ （ 131 cases） ：three cuts and younger than 70 years. Group Ⅲ （29 cases） ： three cuts and older than 70 years. Restults In the number of lymphadenectomy, there was statistical difference between group Ⅰ and group Ⅱ ,group Ⅲ （P 〈0. 05 ） ;The incidence of complication after operation of group Ⅲ was 58.6%, which was higher than that of other groups and there was statistical difference（P 〈0.05）. In motality after operation there was no difference between group Ⅰ and group Ⅲ. There was no statistical difference in one and three years survival rates after operation （ P 〉 0. 05 ）. Conelutlons The neck, chest and abdomen surgical approach can remove lymphnodes clearly and can be adopted actively in the aged people with esophagus carcinoma.