食管癌颈部吻合术后喉返神经损伤24例分析

An Analysis of Recurrent Laryngeal Nerve Injury after Cervical Esophagogastrostomy in 24 Cases with Esophageal Cancer

[目的]探讨食管癌颈部吻合术后喉返神经损伤的原因及其防治措施。[方法]对2005～2010年415例行食管癌颈部吻合术的患者资料进行回顾性分析,其中术后并发喉返神经损伤24例。[结果]24例喉返神经损伤包括22例单侧损伤和2例双侧损伤。喉返神经损伤与肿瘤T分期和TNM分期无关。颈段、胸上段食管癌患者较胸中段及下段食管癌患者易发生损伤(P<0.05);上纵隔淋巴结转移的食管癌患者较无淋巴结转移患者更易发生损伤(P<0.05)。[结论]喉返神经损伤与肿瘤位置及上纵隔淋巴结转移相关。

[Purpose] To investigate the causes and preventive measures of the recurrent laryngeal nerve injury （RLNI） after cervical esophagogastrostomy in patients with esophageal cancer. [Methods] The Clinical data of 415 cases with esophageal cancer in cervical esophagogastrostomy （from 2005 to 2010） were analyzed retrospectively. Of them RLNI occurred in 24 cases. [Results] Of 24 cases with RLNI, 22 cases with unilateral injury and 2 cases with bilateral injury. RLNI was not related to T staging and TNM staging. The RLNI rate in patients with cervical or upper thoracic esophageal carcinoma was higher than that in patients with middle or low thoracic esophageal carcinoma （P〈0.05）. And patients with superior mediastinum lymph node metastasis were more likely to RLNI than patients without node metastasis （P〈0.05）. [Conclusion] RLNI is related to the tumor location and superior mediastinum lymph node metastasis.