摘要
目的:探讨食管鳞癌Mckeown微创与开放手术的临床疗效。方法:回顾性分析2015年5月-2017年12月于宜昌市中心人民医院接受Mckeown术的食管鳞癌患者175例,其中行开放手术85例(包括接受新辅助治疗的45例),微创手术90例(包括接受新辅助治疗的48例)。结果:在是否接受新辅助治疗的亚组分析显示,微创手术相较于开放手术,手术时间更短,术中出血更少,住院时间更短,差异均有统计学意义(均P<0.05);微创组吻合口瘘和肺炎的发生率明显低于开放组(均P<0.05);两组总生存期(OS)无统计学差异(P>0.05)。开放手术组和微创手术组中均发现,新辅助治疗患者的OS明显优于未行新辅助治疗者(均P<0.05)。结论:Mckeown微创食管切除术围手术期效果优于开放手术,但二者远期疗效相当,新辅助治疗可能改善其远期预后。
Objective:To investigate the clinical efficacy of minimally invasive and open McKeown surgery for esophageal squamous cell carcinoma.Methods:A total of 175 patients with esophageal squamous cell carcinoma who received McKeown esophagectomy in Yichang Central People's Hospital from May 2015 to December 2017 were retrospectively analyzed.There were 85 patients underwent open surgery with 45 cases received neoadjuvant therapy,and another 90 patients underwent minimally invasive surgery with 48 cases received neoadjuvant therapy.Results:Subgroup analysis of whether or not to receive neoadjuvant therapy suggested that patients in the minimally invasive surgery group had shorter operation time,less intraoperative bleeding and shorter hospital stay than those of the open surgery group,with statistically significant differences(all P<0.05).The incidence of anastomotic fistula and pneumonia in the minimally invasive group was significantly lower than that in the open group(both P<0.05).There was no significant difference in overall survival(OS)between the minimally invasive group and the open group(P>0.05).The OS was significantly better for patients received neoadjuvant therapy both in the open surgery group and the minimally invasive surgery group(both P<0.05).Conclusion:The perioperative effect of minimally invasive McKeown esophagectomy is better than that of open surgery,while the long-term effect was similar,and neoadjuvant therapy may improve the long-term prognosis.
作者
杨泽波
张媛媛
胡旭
Yang Zebo;Zhang Yuanyuan;Hu Xu(Department of Cardiothoracic Surgery,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)
出处
《巴楚医学》
2023年第3期100-104,共5页
Bachu Medical Journal
基金
湖北省教育厅指导性项目(No:B2019018)。
关键词
食管鳞状细胞癌
新辅助治疗
Mckeown术
微创切除术
开放手术
esophageal squamous cell carcinoma
neoadjuvant treatment
McKeown esophagectomy
minimally invasive surgery
open surgery
