检验医学与临床2019，Vol.16Issue(3)：367-370,4.DOI:10.3969/j.issn.1672-9455.2019.03.023
胸腹腔镜下胸中上段食管癌三野淋巴结清扫术的安全性及短期疗效分析
Safety and short-term curative effect analysis of thoracolaparoscopy three-field lymphadenectomy in treatment of upper and middle thoracic esophageal carcinoma
郭孟刚 1胡杰伟 1朱允和 1钟钏 1马幸生1
作者信息
- 1. 四川省遂宁市中心医院胸外科,629000
- 折叠
摘要
Abstract
Objective To investigate and analyze the safety and short-term curative effect of thoracolaparoscopy three-field lymphadenectomy in the treatment of upper and middle thoracic esophageal carcinoma.Methods The clinical data and recent follow-up results of 98 patients with upper and middle thoracic esophageal carcinoma treated in hospital from December 2013 to December 2015 were retrospectively analyzed.All patients underwent thoracolaparoscopy surgery, including 50 cases of three-field lymphadenectomy and 48 cases of two-field lymphadenectomy.The perioperative related indicators, lymph node dissection number, lymph node metastasis rate, postoperative complications, cervical lymph node recurrence rate and survival rate were compared between the two groups.Results The operation time of thoracolaparoscopy three-field lymphadenectomy was longer than that of thoracolaparoscopy two-field lymphadenectomy, the difference was statistically significant (P<0.05) , but there were no statistically significant differences in intraoperative hemorrhage, indwelling thoracic catheterization time and hospitalization time (P>0.05) .The average number of lymph node dissection in the three-field and two-field groups were 22.94±3.26 and 15.41±1.84 respectively, the lymph node metastasis rates were 66.00％ (33/50) and 43.75％ (21/48) respectively, the differences were statistically significant (P<0.05) .The injury rates of recurrent laryngeal nerve in the three-field and the twofield groups were 26.00％ and 10.42％ respectively, the difference was statistically significant (P<0.05) .There were no statistically significant differences in the incidence rates of complications such as anastomotic leakage, chylothorax, pulmonary infection, pulmonary embolism, arrhythmia and gastric emptying disorder between the two groups (P>0.05) .The postoperative 1-year and 2-year recurrence rate of cervical lymph nodes in the three-field group were lower than those in the two-field group (P<0.05) .The postoperative 1-year and2-year survival rates in the three-field group were significantly higher than those in the two-field group (P<0.05) .Conclusion Thoracolaparoscopy three-field lymphadenectomy in the treatment of upper and middle thoracic esophageal carcinoma is safe and feasible, and the lymph node dissection is more thorough, which can reduce the local recurrence rate, increases the postoperative survival rate, and has a certain clinical application value.关键词
食管癌/胸腹腔镜/三野淋巴结清扫术Key words
esophageal cancer/thoracolaparoscopy/three-field lymphadenectomy分类
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郭孟刚,胡杰伟,朱允和,钟钏,马幸生..胸腹腔镜下胸中上段食管癌三野淋巴结清扫术的安全性及短期疗效分析[J].检验医学与临床,2019,16(3):367-370,4.
