220例右胸腹部二切口治疗胸段食管癌的疗效分析

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

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。

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 uppermiddle 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.