摘要
目的:分析胸腔镜食管癌根治术治疗食管癌的临床疗效及影响远期预后的危险因素。方法:选取2017年7月至2018年7月收治的117例食管癌患者,按照随机数字表法分为胸腔镜组(n=58)与对照组(n=59)。观察两组术后疗效及预后情况,单因素分析胸腔镜组内临床病理资料的差异,对比组内并发症发生情况。采用多因素Logistic回归分析食管癌根治术后远期预后的危险因素。结果:胸腔镜组胸腔引流总量、复发转移发生率、住院时间低于传统对照组,淋巴结清扫数量、三年累积生存率高于对照组(P<0.05)。根据胸腔镜组随访结束后的生存情况分为死亡组与常规组,两组患者在肿瘤直径、脉管瘤栓、分化程度方面差异有统计学意义(P<0.05);死亡组术后并发症总发生率高于常规组(P<0.05)。多因素Logistic回归分析显示,肿瘤直径>3 cm、脉管瘤栓、低分化、术后并发症是食管癌患者远期预后的危险因素(P<0.05)。结论:胸腔镜食管癌根治术治疗食管癌的临床疗效更好,可有效提升预后效果,但临床诊疗中仍需针对食管癌远期预后的独立危险因素进行分析,以提高疗效。
Objective:To investigate the curative effect of thoracoscopic radical resection of esophageal cancer and the risk factors of long-term prognosis.Methods:A total of 117 patients diagnosed with esophageal cancer from Jul.2017 to Jul.2018 were selected for the study.The 117 patients were divided into thoracoscopic group(n=58)and traditional control group(n=59)according to random number table method.The postoperative curative effect and prognosis of the two groups were observed.The clinical pathological data differences in the thoracoscopic group were analyzed by univariate analysis,and the complications of the patients in the group were compared.Risk factors for long-term prognosis after radical resection of esophageal cancer were analyzed by multivariate logistic regression.Results:The total amount of thoracic drainage,the incidence of recurrence and metastasis,the hospital stay in the thoracoscopic group were lower than those in the traditional control group,and the number of lymph node dissection and three-year cumulative survival rate were higher than those in the traditional control group(P<0.05).According to the survival of the thoracoscopic group at the end of follow-up,the patients were divided into the death group and the conventional group.There were statistically significant differences in the diameter of the tumor,the blood vessel invasion,and the degree of differentiation between the two groups(P<0.05).Compared with the conventional group,the total incidence of postoperative complications significantly increased in the death group(P<0.05).Multivariate logistic regression analysis showed that tumor length>3 cm,blood vessel invasion,low differentiation and postoperative complications were risk factors for long-term prognosis of esophageal cancer patients(P<0.05).Conclusions:Compared with traditional radical resection of esophageal carcinoma,thoracoscopic radical resection in the treatment of esophageal cancer has higher clinical efficacy,and can effectively improve the prognosis of patients.However,it is
作者
陆世民
常江华
胡江文
冯冬杰
张勤
LU Shi-min;CHANG Jiang-hua;HU Jiang-wen(Department of Thoracic and Cardiac Surgery,Affiliated Nanjing Jiangbei Hospital of Nantong University,Nanjing 210048,China;Department of Thoracic Surgery,Jiangsu Cancer Hospital,the Affiliated Cancer Hospital of Nanjing Medical University)
出处
《腹腔镜外科杂志》
2022年第6期410-414,共5页
Journal of Laparoscopic Surgery
基金
江苏省科技项目(BE2017759)。
关键词
食管肿瘤
食管癌根治术
胸腔镜检查
远期预后
危险因素
Esophageal neoplasms
Radical resection of esophageal cancer
Thoracoscopy
Long-term prognosis
Risk factors
