三种手术方式治疗上段食管癌的近期疗效及并发症比较

Contrastive Analysis of Recent Effect and Complication of Upper Esophageal Cancer with Three Different Surgical approaches

目的:比较三种方式治疗上段食管癌的近期疗效和并发症。方法:回顾性分析2000年1月-2009年12月笔者所在科收治的行手术治疗的上段食道癌患者的临床资料,将其分为右径胸胃代食管胸骨后颈部吻合组(A组)、右径胸结肠代食管胸骨后颈部吻合术组(B组)和经腹、颈食管抽拨胃代食管颈部吻合组(C组),评价术后疗效和并发症情况。采用t检验、χ2检验分析上段食道癌术后疗效和并发症的相关情况。结果:A组肿瘤切除率最好,肺部并发症、吻合口漏高;B组术后胃食管反流最低;C组术后肺部并发症最低,手术创伤小。结论:三种手术方式各有其优缺点和适应证,应根据患者病情选择最佳手术方式。

Objective ：To compare the recent effect and complication of upper esophageal cancer with three different surgical approaches.Methods ：A total of 47 patients with upper esophagectomy of carcinoma were studied from Jan 2000 to Dec 2009 in department of surgery, the second people＇ s hospital of Liuan city.All patients were divided into the right thoracic esophagectomy and gastric pull-up path sternum after cervical anastomosis group（A group）, the right size of thoracic esophagus with colon after sternal anastomosis in the neck and abdominal group（B group）, the cervical esophageal pumping replacement of esophagus with stomach cervical anastomosis group（C group）.All patients＇ complications and efficacy waere recorded.All cases were analyzed by t test and X2 test.Results ：Tumor resection rate of A group was the best, pulmonary complications and anastomotic leakage were high ; The gastroesophageal reflux rate of postoperative was minimum in B group ; Pulmonary complication and surgical trauma of postoperative was minimal in C group.Conclusion ：Three treatment for upper esophageetomy of carcinoma have different complications and efficacy.The three kinds of operation methods have respective advantages, disadvantages and indications, should select optimal operation mode according to patients＇ condition.