不同手术路径治疗胸中段食管癌临床疗效研究

Study on clincial efficacy of different surgical approaches for the treatment of middle thoracic esophageal carcinoma

目的探讨并比较左胸路径、右胸路径治疗胸中段食管癌患者的疗效。方法 88例胸中段食管癌患者,按照序号分为观察组和对照组,每组44例。对照组给予左胸路径治疗,观察组给予右胸路径治疗,比较两组的临床指标及并发症、3年复发情况。结果观察组患者的住院时间(17.21±4.06)d、手术时间(223.4±10.3)min明显短于对照组的(22.46±3.32)d、(303.3±11.1)min,术中出血量(400.7±12.1)ml明显少于对照组(523.4±10.2)ml,淋巴结清除量(50.4±8.5)个明显多于对照组(38.7±5.5)个,差异均具有统计学意义(P<0.05)。术后,观察组并发症发生率22.73%略低于对照组的27.27%,但差异无统计学意义(P>0.05);行3年随访发现,观察组复发率31.82%明显低于对照组的65.91%,差异具有统计学意义(P<0.05)。结论右胸路径治疗胸中段食管癌疗效更为显著,能有效降低术后复发率,值得临床应用。

Objective To investigate and compare the efficacy of left thoracic approach and right thoracic approach in the treatment of middle thoracic esophageal carcinoma. Methods A total of 88 middle thoracic esophageal carcinoma patients were divided by order into observation group and control group. The control group was treated with left thoracic approach, and the observation group was treated with right thoracic approach. Comparison were made on clinical indicators, complications and 3-year recurrence in two groups. Results The observation group had obviously shorter hospitalization time as（17.21±4.06）d, operation time as（223.4±10.3） min than（22.46±3.32） d and（303.3±11.1） min, obviously less intraoperative bleeding volume as（400.7±12.1） ml than（523.4±10.2） ml in the control group, and obviously more number of lymph node clearance as（50.4±8.5） pieces than（38.7±5.5） pieces in the control group. Their difference was statistically significant（P〈0.05）. After operation, the observation group had a little lower incidence as 22.73% than 27.27% in the control group, but the difference was not statistically significant（P〉0.05）. After 3 year of follow-up, the observation group had obviously lower recurrence rate as 31.82% than 65.91% in the control group, and the difference was statistically significant（P〈0.05）. Conclusion Right thoracic approach provides remarkable efficacy in treating middle thoracic esophageal carcinoma, and it can effectively reduce postoperative recurrence rate. It is worthy of clinical application.