经左胸单切口和经右胸-腹部-颈部三切口治疗中段食管癌的手术疗效比较

Comparison of surgical efficacy of Single left thoracal incision and right chest-belly-neck three-incision for middle esophageal carcinoma.

目的:比较经左胸单切口和经右胸-腹部-颈部三切口治疗中下段食管癌的手术疗效。方法:选择将2011年1月～2013年1月我院胸心外科收治的中下段食管癌患者60例,随机分成2组,经左胸单切口组(A组,30例),经右胸-腹部-颈部三切口(B组,30例)。分析2组患者手术时间、术后住院时间、淋巴结清扫数目、食管上切缘阳性率、术后留置胸管时间、术后并发症等指标。结果:(1)A组手术时间、术后住院时间和清扫淋巴结数目明显少于B组(P<0.05)。2组的留置胸管时间和食管上切缘阳性率无明显差异(P>0.05);(2)A组术后1周肺部感染发生率比B组明显减少(P<0.05)。结论:与经左胸单切口比较,经右胸-腹部-颈部三切口淋巴结清扫数目更彻底,但手术时间较长,术后肺部感染率较高。

Objective：To comparison the surgical efficacy of single left thoracal incision and right chest - belly - neck three - incision for middle esophageal carcinoma.Methods：From Jan 2011 to Jan 2013,60 patients with esophageal carcinoma were recuited and divided into two proups each content 30 patients：single left thoracal incision group（A group） and right chest - belly - neck three - incision group（B group）.The operation duration,postoperative hospitalization time,the number of lymph node dissection,positive staining rates of incisal edge of the specimen,the average duration of chest tube drainage,postoperative complication were analyzed.Results：①Compared with the B group,the operation duration,postoperative hospitalization time and the number of lymph node dissection were less than those in A group （all P0.05）.There were no significant differences of positive staining rates of incisal edge of the specimen and the average duration of chest tube drainage between the two groups（P0.05）.②The incidence rate of pulmonary infection in A group was significantly less than B group（all P0.05）.Conclusion：Compared with the single left thoracal incision,right chest - belly - neck three - incision could provide a wider extent of lymphadenectomy,but its operation time may be longer and a higher incidence of pulmonary infection.