摘要
目的:分析探讨不同手术入路对食管癌切除患者的淋巴结清扫及治疗效果影响。方法:选取我院于2016年5月至2018年5月期间收治的90例食管癌患者进行回顾性研究,根据手术入路的不同将两组患者划分为甲乙两组,其中甲组患者均采用lvor-Lewis手术,而乙组患者则为左胸手术,对比两组患者的腹部和胸腔淋巴结清扫数量以及术后并发症发生率等相关指标。结果:甲组患者的上纵膈淋巴结转移率为24.00%,显著高于乙组患者的10.00%(χ~2=6.945,P <0.05);甲组患者的气管旁右三角淋巴结转移率为20.00%,显著高于乙组患者的0(χ~2=7.495,P <0.05);两组患者下纵膈和腹部区域的淋巴结转移情况并无明显差异(均P>0.05)。两组患者的心律失常、吻合口狭窄、胃排空延缓、吻合口瘘、胸部感染等术后不良反应发生率均无明显差异(均P>0.05)。结论:相对于左胸入路术式而言,对食管癌患者采用lvor-Lewis术式二野清扫的转移淋巴结更彻底,治疗效果更佳,值得在临床上加以广泛推广运用。
Objective: To analyze the effect of different operative approaches on lymph node dissection and treatment of esophageal cancer patients. Methods: 90 patients with esophageal cancer admitted to our hospital from May 2016 to May 2018 were retrospectively studied. According to the different surgical approaches,the two groups were divided into two groups: group A was treated with lvor-Lewis operation,while group B was treated with left chest operation. The number of abdominal and thoracic lymph node dissection and the incidence of complications were compared between the two groups. Results: The metastatic rate of upper mediastinal lymph nodes in group A was 24.00%,which was significantly higher than that in group B 10.00% (χ~2=6.945,P <0.05),and that in group A was 20.00%,which was significantly higher than that in group B (χ~2=7.495,P <0.05). There was no significant difference in lymph node metastasis between the lower mediastinum and abdominal region between the two groups (P >0.05). The incidence of arrhythmia,anastomotic stenosis,delayed gastric emptying,anastomotic fistula and chest infection were not significantly different between the two groups (all P > 0.05).). Conclusion: Compared with the left thoracic approach,lvor-Lewis two-field dissection is more thorough and effective in the treatment of metastatic lymph nodes in patients with esophageal cancer,which is worthy of wide clinical application.
作者
马生茂
党继芳
张华
吕军其
陈永祥
马伟林
MA Shengmao(Ningxia Hui Autonomous Region People's Hospital,Ningxia Yinchuan750004,China)
出处
《河北医学》
CAS
2019年第3期664-667,共4页
Hebei Medicine
基金
宁夏回族自治区自然科学基金资助项目
(编号:2014-211C064)
关键词
食管癌
手术入路
淋巴结清扫
Esophageal cancer
Operative approach
Lymph node dissection
