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目的:探讨胸段食管癌三种常用术式方法的选择原则、手术疗效及术后并发症的比较。方法:本研究选择临床确诊无广泛转移胸段食管癌60例,分别采用常规左胸入路手术20例,右胸、上腹部二切口手术18例和右胸、腹、颈部三切口手术22例,均为根治性手术,术中清扫淋巴结,并送病理检查。分析不同手术径路对食管癌治疗效果及术后并发症的影响。结果:本组研究病例全部顺利完成根治性手术,术中淋巴结活检检出有淋巴结转移25例,淋巴结转移率41.67%(25/60)。本研究组发生并发症患者13例,其中吻合口瘘4例,胃排空障碍4例,肺部并发症5例。其中通过右胸、腹、颈部三切口入路手术并发症最高,达41.25%,与其它组别相比均有明显差异,P<0.05。结论:胸段食管癌手术方式的选择应因人而异,正确的选择有助于提高肿瘤切除率、淋巴结清扫率及降低肿瘤复发率,此外不同手术方式的个体化选择是降低术后并发症和提高生存质量的有效手段。
Objective: To explore the principle of selection, surgical efficacy and postoperative complications of thoracic esophageal cancer. Methods: Sixty cases of thoracic esophageal carcinoma without extensive metastasis were selected in this study. Twenty patients underwent conventional left thoracic surgery, 18 underwent right thoracic and upper abdominal incision, and three incisions on the right chest, abdomen and neck respectively Cases, are radical surgery, lymph node dissection, and send pathological examination. To analyze the effect of different surgical approaches on esophageal cancer treatment and postoperative complications. Results: All the cases in this study successfully completed radical surgery. There were 25 cases with lymph node metastasis and 41.67% (25/60) lymph node metastasis detected by lymph node biopsy in operation. The study group of patients with complications occurred in 13 cases, of which 4 cases of anastomotic leakage, gastric emptying disorders in 4 cases, 5 cases of pulmonary complications. Among them, the complications of operation through the right thoracic, abdominal and neck incisions were the highest (41.25%), which were significantly different from other groups (P <0.05). Conclusion: The choice of thoracic esophageal surgery should vary from person to person, the correct choice will help to improve the tumor resection rate, lymph node dissection rate and reduce the tumor recurrence rate, in addition to different methods of operation individualized choice is to reduce postoperative complications And improve the quality of life of effective means.