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目的探讨胸段食管癌的合理术式。方法回顾性收集开胸治疗胸段食管癌患者2213例的临床资料,其中颈部吻合1286例,胸内吻合927例,并对两组的临床资料、生存资料进行对比分析。结果颈部吻合组术后吻合瘘发生率、喉返神经损伤发生率高(P<0.01),切缘癌残留率、胃食管反流发生率低于胸内吻合组(P<0.05)。两组住院死亡率及1年生存率差异无显著性(P>0.05),但根治性切除率及5年生存率颈部吻合组高于胸内吻合组(P<0.05)。结论胸段食管癌应行食管次全切除食管胃颈部吻合术,以改善预后,提高生命质量。
Objective To investigate the reasonable operation of thoracic esophageal cancer. Methods The clinical data of 2213 patients with thoracic esophageal cancer underwent thoracotomy were collected retrospectively. Among them, 1286 were anastomosed with thoracic anastomosis and 927 were thoracic anastomosed with thoracic esophageal cancer. The clinical data and survival data were compared between the two groups. Results The incidence of anastomotic fistula and recurrent laryngeal nerve injury in the anastomosis group were higher than those in the anastomosis group (P <0.01). The incidences of residual cancer and gastroesophageal reflux were lower than those in the anastomosis group (P <0.05). There was no significant difference in in-hospital mortality and 1-year survival rate between the two groups (P> 0.05). However, the rate of radical resection and 5-year survival rate in the cervical anastomosis group were higher than those in the thoracic anastomosis group (P <0.05). Conclusion Thoracic esophageal cancer should be performed subtotal esophagogastrostomy esophagogastrostomy in order to improve the prognosis and improve the quality of life.