摘要
目的探讨局部进展期食管癌新辅助放化疗(NCRT)后微创食管癌根治术(MIE)的临床疗效和安全性。方法根据NCRT后手术方式的不同将135例局部进展期食管癌患者分为开放食管癌根治术(OE)组(n=62)和MIE组(n=73),比较两组患者的手术相关指标、术后并发症发生情况和术后复发转移情况。结果MIE组患者的手术时间、胸腔引流管留置时间、术后住院时间均明显短于OE组,术中出血量明显少于OE组,淋巴结清扫数目明显多于OE组,差异均有统计学意义(P<0.01)。两组患者术后感染、喉返神经损伤、心律失常、吻合口瘘、食管气管瘘的发生率比较,差异均无统计学意义(P>0.05);OE组患者反流性食管炎和胃炎的发生率均高于MIE组,差异均有统计学意义(P<0.05)。术后12、18、24个月,两组患者的复发转移率比较,差异均无统计学意义(P>0.05)。结论局部进展期食管癌NCRT后MIE是安全可行的,与OE相比,MIE未增加术后严重并发症的发生率,且其创伤更小,患者术后住院时间较短,机体恢复更快。
Objective To investigate the clinical efficacy and safety of minimally invasive esophagectomy(MIE)in patients with locally advanced esophageal cancer after neoadjuvant chemoradiotherapy(NCRT).Method A total of 135 patients with locally advanced esophageal cancer were divided into the open esophagectomy(OE)group(n=62)and MIE group(n=73)according to different surgical methods after NCRT.The surgical-related indicators,postoperative complications,and postoperative recurrence and metastasis were compared between the two groups.Result The operation time,indwelling thoracic drainage tube time,and postoperative hospital stay of the MIE group were significantly shorter than those of the OE group,the intraoperative blood loss volume was significantly less than that of the OE group,and the number of lymph node dissection was significantly higher than that of the OE group,the differences were statistically significant(P<0.01).There was no significant difference in the incidences of postoperative infection,recurrent laryngeal nerve injury,arrhythmia,anastomotic leakage,and esophagotracheal fistula between the two groups(P>0.05).The incidence of reflux esophagitis and gastritis in the OE group was higher than that in the MIE group,and the difference was statistically significant(P<0.05).At 12,18,and 24 months after surgery,there was no significant difference in the recurrence and metastasis rate between the two groups(P>0.05).Conclusion MIE after NCRT for locally advanced esophageal cancer is safe and feasible.MIE does not increase the incidence of serious postoperative complications and with less trauma,shorter postoperative hospital stay,and faster recovery compared with OE.
作者
赵雄飞
徐冬梅
张伟
吴军
贾杰
徐鹏
ZHAO Xiongfei;XU Dongmei;ZHANG Wei;WU Jun;JIA Jie;XU Peng(Department of Cardiothoracic Surgery,the Third Hospital of Mianyang,Mianyang 621000,Sichuan,China)
出处
《癌症进展》
2022年第1期49-51,66,共4页
Oncology Progress
关键词
局部进展期食管癌
新辅助放化疗
开放食管癌根治术
微创食管癌根治术
locally advanced esophageal cancer
neoadjuvant chemoradiotherapy
open esophagectomy
minimally invasive esophagectomy
