食管癌根治术行隆突下淋巴结清扫的临床价值研究

The clinical value of radical resection of esophageal carcinoma with subcarinal lymph node dissection

目的探析食管癌根治术中行隆突下淋巴结清扫的临床价值。方法回顾性分析康平县人民医院于2018年7月至2019年7月收治的82例食管癌根治术患者临床资料,将行隆突下淋巴结清扫的患者作为观察组(41例),将不进行隆突下淋巴结清扫的患者作为对照组(41例),比较两组患者的淋巴结清扫情况、手术相关指标及并发症发生率。结果82例患者,清扫淋巴结902枚,其中淋巴结转移26例,占31.71%。观察组手术时间(206.64±12.24)min,出血量(227.48±14.67)mL,长(多)于对照组,P<0.05;观察组肺部并发症发生率17.07%,高于对照组,P<0.05,观察组切口感染发生率9.76%,胃排空障碍发生率2.44%,与对照组相比,P>0.05。结论在食管癌根治术中,需要充分考虑到患者体质及肿瘤特性行隆突下淋巴结清扫,认为一般在肿瘤侵及食管纤维膜时进行,但是可能会增加患者手术时间及出血量,加大并发症发生率。

Objective:To explore the clinical value of subcarinal lymph node dissection in radical resection of esophageal carcinoma.Methods:The clinical data of 82 patients with esophageal carcinoma treated in Kangping County People's Hospital from July 2018 to July 2019 were retrospectively analyzed.The patients who underwent subcarinal lymph node dissection were selected as the observation group(41 cases),and the patients who did not undergo the lymph node dissection were regarded as the control group(41 cases).The lymph node dissection,operation related indexes and incidence of complications were compared between the two groups.Results:In 82 patients,902 lymph nodes were removed,among which 26 cases(31.71%)were lymph node metastasis.The operation duration of the observation group was(206.64±12.24)min,the bleeding volume was(227.48±14.67)mL,which was longer(more)than that of the control group,P<0.05;the incidence of pulmonary complications in the observation group was 17.07%,which was higher than that in the control group,P<0.05;the incidence of incision infection and gastric emptying disturbance in the observation group was 9.76%,2.44%respectively,compared with the control group,P>0.05.Conclusion:In radical resection of esophageal cancer,it is necessary to fully consider the patient's physique and tumor characteristics,and perform the lymph node dissection under the carina.It is generally considered that the dissection is performed when the tumor invades the esophageal fibrous membrane,but it may increase the operation time and blood loss,and increase the incidence of complications.