摘要
目的:探讨Ⅲ期食管癌新辅助化疗后行腔镜手术的临床疗效。方法:收集收治的Ⅲ期食管癌患者的临床资料。新辅助化疗后行腔镜手术者38例,设为观察组;单纯行腔镜手术者45例,设为对照组。比较两组患者围术期指标(手术时间、术中出血量、胸管留置时间、淋巴结清扫数目、淋巴结转移率)、近期疗效、术后并发症(吻合口瘘或狭窄、喉返神经损伤、肺部感染、心率失常)发生率、复发率和1年生存率、中位生存时间,观察治疗前后生活质量[食管癌专用生活质量量表(QLQ-OES18)]变化情况。结果:两组患者手术时间、术中出血量、胸管留置时间、淋巴结清扫数目、术后并发症发生率比较差异无统计学意义(均P>0.05);观察组患者淋巴结转移率低于对照组,近期治疗总有效率高于对照组,术后复发率低于对照组,1年生存率高于对照组(均P<0.05),中位生存时间为32个月,高于对照组17个月(P<0.05);术后3个月,两组患者吞咽功能评分较术前升高,且观察组高于对照组(P<0.05),进食不适、反流、疼痛、吞咽梗阻、口干、咽口水困难、食欲减退、咳嗽、言语等症状评分均较术前降低,且观察组低于对照组(均P<0.05)。结论:新辅助化疗后行腔镜手术可提高Ⅲ期食管癌患者的手术根治率,减少淋巴结转移和术后复发率,改善生存率和生活质量。
Objective:To explore the clinical efficacy of endoscopic surgery after neoadjuvant chemotherapy for stageⅢesophageal cancer.Methods:The clinical data of patients with stageⅢesophageal cancer were collected.38 patients who underwent endoscopic surgery after neoadjuvant chemotherapy were set as observation group,and 45 patients who underwent endoscopic surgery alone were set as control group.Perioperative indicators(surgery time,intraoperative blood loss,chest tube indwelling time,number of lymph node dissection,lymph node metastasis rate),short-term efficacy,incidence rates of postoperative complications(anastomotic fistula or stenosis,recurrent laryngeal nerve injury,lung infection,arrhythmia),recurrence rate,1-year survival rate and median survival time were compared between the two groups.The quality of life(QLQ-OES18)was observed before and after treatment.Results:There were no significant differences in the surgery time,intraoperative blood loss,chest tube indwelling time,number of lymph node dissection and incidence rates of postoperative complications between the two groups(all P>0.05).The lymph node metastasis rate in observation group was lower than that in control group,and the total effective rate of short-term treatment was higher than that in control group,and the postoperative recurrence rate was lower than that in control group,and the 1-year survival rate was higher than that in control group(all P<0.05);the median survival time was higher than that in control group(32 months vs.17 months,P<0.05).At 3 months after surgery,the swallowing function scores in the two groups were higher than those before surgery,and the score in observation group was higher than that in control group(all P<0.05);the scores of symptoms of eating discomfort,reflux,pain,swallowing obstruction,dry mouth,swallowing difficulty,loss of appetite,cough and speech were lower than those before surgery,and the scores in observation group were lower than those in control group(all P<0.05).Conclusion:Endoscopic surgery after neoa
作者
宋养荣
程蒿
刘佳
强准
张新伟
SONG Yangrong;CHENG Hao;LIU Jia;QIANG Zhun;ZHANG Xinwei(Department of Thoracic Surgery,Shaanxi Provincial Cancer Hospital,Xi’an 710061,China)
出处
《陕西医学杂志》
CAS
2021年第11期1358-1361,共4页
Shaanxi Medical Journal
基金
陕西省科技计划项目(2020SF-289)。
关键词
Ⅲ期食管癌
新辅助化疗
腔镜手术
生活质量
生存曲线
StageⅢesophageal cancer
Neoadjuvant chemotherapy
Endoscopic surgery
Quality of life
Survival curve
