两种手术方式治疗下段食管癌的临床研究分析.docVIP

两种手术方式治疗下段食管癌的临床分析 高杨，周海英 （河北唐山工人医院胸外科 063000） 摘 要：目的 对治疗下段食管癌的两种不同手术方式—左胸单切口术式和右胸及上腹两切口术式进行比较和评价，为下段食管癌临床手术方式的选择提供依据。方法 回顾分析235例下段食管癌手术病例，按手术方式将其分为左胸后外侧单切口组和右胸+上腹正中两切口组。比较两组病例的手术时间、住院时间、胸腔引流管留置时间、淋巴结清扫数目、术后主要并发症的发生率及食管上切缘阳性率。结果 两组在手术时间、淋巴结清扫数目、住院时间等方面有显著差别（p0.05），单切口组和两切口组相比在术后并发症方面无统计学差异。结论 从两组病例的比较又可以看出左胸单切口组比右胸+上腹两切口组手术时间更短，创伤小、患者恢复快，住院时间短；右胸+上腹部两切口组比左胸单切口组视野暴露好，清扫淋巴结清扫彻底；两组在围术期并发症发生率方面无显著差别。 关键词：下段食管癌；手术方式；左胸单切口 The clinical research of two kinds of operation approach to treat the lower thoracic esophageal carcinoma patients Gao Yang，Zhou Haiying （Thoracic surgery of Tangshan Workers Hospital of Heibei Province 063000，China） Abstract：Objective To compare and evaluate the two surgical approaches, the left thoracal single incision and the right thoracal and upper epigastric two incision operation to treat the lower?thoracic esophageal carcinoma, so as to provide theoretical basis for the lower esophageal cancer clinical operation mode selection Methods to review retrospectively 235 lower?thoracic esophageal carcinoma cases. To divide them into the left thoracic posterior single incision group and right thoracic abdominal median two incision group.To compare the clinical and pathological index: the operative time, the number of the lymph nodes cleaning, the incidence of postoperative complications, upper esophageal positive margin rate, length of stay and thoracic cavity drainage tube indwelling time between the two groups. Results the index of two groups’ data?in?the operation time, the number of the lymph nodes cleaning and length of stay was significant different(p0.05);The difference of the Single incision group and the two incision group in the postoperative complications aspect was not statisitically significant. Conclusion By omparing the two groups, we can see the single incision group has shorter operation time, Smaller wound, faster recovery and shorter hospitalization time. The double incisions group has advantages in the exposure of the opera