摘要
目的回顾性分析两种不同手术路径治疗胸中段食管癌的疗效。方法研究纳入107例胸中段食管癌患者,根据手术路径不同分为两组:左胸入路组和Ivor-lewis组。采用Kaplan-Meier曲线和COX回归分析比较两组患者的生存差异,并用方差分析和非参数检验比较术后并发症、淋巴结切除情况以及其他临床因素在两组间的差异。结果患者的一般特征、总体生存时间(P=0.315)、无复发生存时间(P=0.246)、术后胸腔总引流量(P=0.241)、淋巴结切除个数(P=0.065)、阳性淋巴结个数(P=0.188)等在两组间均无统计学差异。左胸入路组患者失血量显著少于Ivor-lewis组(P=0.007),手术时间也明显较短(P=0.042)。COX回归分析显示,T分期(P=0.001)、N分期(P=0.007)和转移淋巴结率(M LR,P=0.040)均为预后的独立危险因素。结论 Ivor-lew is和左胸入路均为胸中段食管癌手术的可选路径。
Objective To compare the efficacy of two different surgical routes for operable esophageal squamous cell carcinoma （ESCC）.Methods A total of 107 patients with middle thoracic ESCC were enrolled and divided into two groups：left transthoracic approach group and Ivor-lewis approach group.Cox regression analysis and Kaplan-Meier curves were used to explore the difference of survival in the two groups.Postoperative complications,information on lymph node dissection and other clinical factors were compared using non-parametric test and Chi-Square test.Results There were no significant differences between the two groups in the patients’characteristics,overall survival （P=0.315）,recurrence-free survival （P=0.246）,chest drainage volume （P=0.241）,number of resected （P=0.065） and positive lymph nodes （P=0.188）.However,blood loss （P=0.007）and operation time （P=0.042）were sig-nificantly less or shorter in left transthoracic approach group.T status （P=0.001）,N status （P=0.007）,as well as metastatic lymph node ratio （MLR,P=0.040）,were shown as independent prognostic risk factors by COX regression analysis.Conclusion Both Ivor-Lewis approach and left transthoracic approach are optional surgical routes for oper-able middle thoracic ESCC.
出处
《山东大学学报（医学版）》
CAS
北大核心
2015年第1期67-72,共6页
Journal of Shandong University:Health Sciences
基金
山东省科技发展计划(2012GG0021836)
关键词
食管鳞癌
食管切除术
淋巴结清扫
Esophageal squamous cell carcinoma Esophagectomy Lymph node excision
