两种手术方式治疗下段食管癌的临床研究

The clinical research of two kinds of operation approach to treat patients with lower thoracic esophageal carcinoma

目的对治疗下段食管癌的两种不同手术方式进行比较和评价,为下段食管癌临床手术方式的选择提供依据。方法回顾分析235例下段食管癌手术病例,按手术方式将其分为左胸后外侧单切口组(单切口组)和右胸联合上腹正中双切口组(双切口组)。比较两组病例的手术时间、住院时间、胸腔引流管留置时间、淋巴结清扫数目、术后主要并发症的发生率及食管上切缘阳性率。结果两组在手术时间、淋巴结清扫数目、住院时间等方面比较差异有统计学意义(P<0.05),单切口组和双切口组相比在术后并发症方面比较差异无统计学意义(P>0.05)。结论两种手术方法比较有各自的优点和弊端,在临床上应该根据患者病情,合理选择手术方式。

Objective To compare and evaluate two different surgical methods for the treatment of the lower esophagus,and to provide the basis for the lower segment esophageal cancer surgery choices. Methods A total of 235 cases of esophageal cancer sur-gery cases were retrospectively analyzed, which were divided into the left chest posterolateral single-incision group and the right chest joint epigastric middle of the two-incision group. The clinical and pathological indexes were compared between the two groups, including the operative time, the number of the lymph nodes cleaning, the incidence of postoperative complications, upper e-sophageaf positive margin rate,length of stay and thoracic cavity drainage tube indwelling time. Results The index of two groups＇ data in the operation time, the number of the lymph nodes cleaning and length of stay was significant different（P〈0.05）;The difference of the single incision group and the two incision group in the postoperative complications aspect was not statistically sig nificant（P〉0. 05）. Conclusion Two surgical techniques have their own advantages and disadvantages, which in clinical practice should be based on the patient＇s condition,reasonable choice of surgical approach.