新辅助放化疗联合微创手术治疗局部进展期食管癌的病例对照研究

A Control Study of Neoadjuvant Chemoradiotherapy Combined with Minimally Invasive Surgery for Locally Advanced Esophageal Cancer

目的 探讨局部进展期食管癌新辅助治疗后行微创手术的安全性和有效性.方法 回顾性分析中国医科大学附属第四医院胸外科2016年—2017年连续收治的局部进展期食管癌患者120 例,随机分为实验组和对照组.其中接受新辅助治疗后手术的患者60 例为实验组.对照组60 例患者为直接接受手术.结果 两组患者在性别、年龄、肿瘤部位及临床分期方面差异无统计学意义(P均>0.05).实验组的手术时间、术中失血量、R2切除率、淋巴结清扫数量及淋巴结转移优于对照组,差异有统计学意义(P<0.05);实验组患者术后并发症、术后住院时间及术后30 d死亡发生率均优于对照组(P<0.05).结论 对进展期食管癌患者采用新辅助放化疗联合微创手术治疗方案,可以降低肿瘤复发、转移的风险,术后并发症的发生率也明显降低,提高了安全性.

Objective To evaluate the safety and efficacy of minimally invasive surgery after neoadjuvant treatment for locally advanced esophageal cancer.Methods A retrospective analysis was made on 120 patients with locally advanced esophageal cancer from 2016 to 2017in thoracic surgery of the Fourth Affiliated Hospital of China Medical University.They were divided into experimental group and control group.Experimental group patients receive neoadjuvant treatment and surgery;control group only receive surgery.Results There was no significant difference in sex,age,tumor location and clinical stage between the two groups.The operation time,blood loss and R2 resectability rate,lymph node dissection and lymph node metastasis in the experimental group were significantly higher than those in the control group (P <0.05).The postoperative complications, postoperative hospitalization time and 30 days mortality rate in the experimental group were better than those in the control group (P <0.05).Conclusion Neo-adjuvant chemotherapy combined with minimally,invasive surgery can reduce the risk of tumor recurrence and metastasis in patients with advanced esophageal cancer.