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目的比较经左颈胸二切口术与经右颈胸腹三切口术治疗食管癌的疗效。方法选择2009年10月至2013年10月间收治的46例食管癌患者作为观察组,选取同期收治的52例食管癌患者作为对照组,观察组给予经左颈胸二切口术治疗,对照组给予经右颈胸腹三切口术治疗,对比分析两组患者治疗后手术并发症发生率、手术期病死率、1年生存率、3年生存率和5年生存率以及生活质量。结果观察组并发症发生率和围手术期死亡率分别为15.2%和2.2%,明显低于对照组的36.5%和15.4%,差异有统计学意义(P<0.05)。观察组患者1年生存率、3年生存率与对照组比较,差异无统计学意义(P>0.05);5年生存率明显高于对照组(P<0.05)。观察组患者进餐后胸闷不适感和体重下降发生率明显低于对照组,差异有统计学意义(P<0.05)。两组患者食欲不振、吞咽困难、腹泻、反酸发生率比较,差异无统计学意义(P>0.05)。结论与经右颈胸腹三切口术比较,经左颈胸二切口术治疗食管癌能有效降低患者手术并发症发生率、围手术期死亡率、进餐后胸闷不适感、体重下降发生率,提高5年生存率,效果较为理想,具有很好的临床应用推广价值。
Objective To compare the curative effect of esophageal cancer treated with left cervical-neck-two incision and right-neck-thoraco-abdominal incision. Methods Forty-six patients with esophageal cancer who were treated from October 2009 to October 2013 were selected as the observation group. Fifty-two patients with esophageal cancer who were treated at the same period were selected as the control group. The patients in the observation group were treated with left-neck-throat incision and the control group The patients were treated with right neck, thoracoabdominal and abdominal incision. Comparisons were made between the two groups in the incidence of postoperative complications, operative mortality, 1-year survival, 3-year survival, 5-year survival and quality of life. Results The incidence of complications and perioperative mortality in the observation group were 15.2% and 2.2%, respectively, which were significantly lower than those in the control group (36.5% and 15.4%, P <0.05). The 1-year survival rate and 3-year survival rate in the observation group were not significantly different from those in the control group (P> 0.05). The 5-year survival rate was significantly higher in the observation group than in the control group (P <0.05). The incidence of chest discomfort and weight loss in the observation group was significantly lower than that in the control group (P <0.05). Two groups of patients with loss of appetite, difficulty swallowing, diarrhea, acid reflux rate, the difference was not statistically significant (P> 0.05). Conclusions Compared with the right cervical, thoracic and abdominal incision, the two incisions for the treatment of esophageal cancer can effectively reduce the incidence of postoperative complications, perioperative mortality, chest discomfort after eating, the incidence of weight loss, and increase 5-year survival rate, the effect is more ideal, with good clinical application of promotional value.