左胸后外侧单切口与右胸后外侧及腹正中双切口治疗食管癌的临床效果比较

Comparison Study of Clinical Effect of Left Chest Posterolateral Single Incision Operation and Right Chest Posterolateral with Ventral Midline Double Incision Operation for Treatment of Esophageal Cancer

目的 比较左胸后外侧单切口与右胸后外侧及腹正中双切口治疗食管癌的效果。方法收集2009年5月至2010年5月在辽阳市中心医院治疗的食管癌患者93例临床资料进行回顾性研究。93例患者按照手术方式分为左胸后外侧单切口组（单切口组）和右胸后外侧及腹正中双切口组（双切口组）。对两组患者的手术时间、淋巴结清扫数目、引流管留置时间、住院时间以及并发症发生情况进行比较,统计患者术后1年、2年、3年、4年和5年的生存率。结果 双切口组患者的手术时间显著长于单切口组[（267.5±13.1）min比（223.4±12.2）min,P〈0.01];双切口组手术清扫淋巴结数目显著多于单切口组[（11.6±1.1）个比（7.4±1.0）个,P〈0.01];双切口组引流管留置时间与单切口组比较差异无统计学意义[（6.1±0.6）d比（6.2±0.6）d,P〉0.05];双切口组患者住院时间明显长于单切口组[（15.7±1.3）d比（13.07±1.34）d,P〈0.01]。术后两组患者肺部、乳糜胸、吻合口瘘、喉返神经损伤、吻合口狭窄以及胃排空障碍等并发症发生率比较差异无统计学意义（P〉0.05）。两组患者术后1~5年的生存率比较,差异无统计学意义（P〉0.05）。结论 左胸后外侧单切口与右胸后外侧及腹正中双切口治疗食管癌各具优势,其治疗效果相似,但最终结论有待进一步研究证实。

Objective To study the effect and prognosis of left chest posterolateral single incision operation and right chest posterelateral with ventral midline double incision operation on esophageal cancer. Methods The clinical data of 93 esophageal cancer patients treated in Liaoyang City Central Hospital from May 2009 to May 2010 were retrospectively analyzed. According to the treatment methods, the patients were divided into left chest posterolateral single incision operation group（ single incision operation group） and right chest posterolateral with ventral midline double incision operation （ double incision operation group）. The operative time, number of dissected lymph node, drainage tube indwelling time, hospital stay time, complica- tions and the 1,2,3,4,5 years survival rates of the two groups were compared. Results The operative time of the double incision operation group was significantly longer than the single incision operation group [ （267.5 ±13.1 ） min vs （223.4 ± 12.2） min,P 〈0. 01 ] ,the number of dissected lymph node was more than the single incision operation group [ （11.6± 1.1 ） vs （7. 4 ± 1.0 ） months, P 〈 0. 01 ], the drainage tube indwelling time of the two groups had no statistically significant difference [ （ 6. 1 ± 0. 6 ） d vs （6.2 ±0. 6 ） d ,P 〉 0. 05 ], the hospital stay time of the double incision operation group was significantly longer than the single incision operation group [ （ 15.7 ±1.3 ） d vs （ 13. 1 ± 1.3 ） d,P 〈 0. 01 ]. The incidence of chylo- thorax, fistula of anastomosis, recurrent laryngeal nerve injury, anastomotic stenosis and gastric emptying of the two groups had no statistically significant difference （P 〉 0. 05 ）. There was no significant difference on 1,2,3,4,5 year survival rates after surgery between the two groups （P 〉 0. 05 ）. Conclusion Left chest posterolateral single incision operation and right chest posterolateral with ventral midline double incision operation treatment of esophageal cancer each hasr own advantages, with similar treatment effect, though the final conclusion still needs further research to confirm.