两种手术方式治疗下段食管癌的临床研究分析

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1、两种手术方式治疗下段食管癌的临床硏究分桩高杨，周海英(河北唐山工人医院胸外科063000)摘要：对治疗下段食管癌的两种不同手术方式一左胸单切口术式利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。方法冋顾分析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也切口组和右胸+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、术后主耍并发症的发空率及食管上切缘阳性率。结果两组在手术时间、淋巴结淸扫数目、住院时间等方而有显著差别(卩〈0.05),单切口

2、组和两切口组相比在术后并发症方而无统计学差异。结论从两组病例的比较又町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,淸扫淋巴结清扫彻底；两组在围术期并发症发牛率方面无显著差别。关键词：下段食管癌；手术方式：左胸单切口TheclinicalresearchoftwokindsofoperationapproachtotreatthelowerthoracicesophagealcarcinomapatientsGaoYang,ZhouH

3、aiying(ThoracicsurgeryofTangshanWorkers'HospitalofHeibeiProvince063000,China)Abstract：ObjectiveTocompareandevaluatethetwosurgicalapproaches,theleftthoracalsingleincisionandtherightthoracalandupperep谊astrictwoincisionoperationtotreatthelowerthoracicesophagealcar

4、cinoma,soastoprovidetheoreticalbasisfortheloweresophagealcancerclinicaloperationmodeselectionMethodstoreviewretrospectively235lowerthoracicesophagealcarcinomacases・lbdivide(hemintotheleftthoracicposteriorsingleincisiongroupandrightthoracicabdominalmediantwoinci

5、siongroup.locomparetheclinicalandpathologicalindex:theoperativetime,thenumberofthelymphnodescleaning,theincidcnccofpostoperativecomplications,upperesophagealpositivema團inrate,lengthofstayandthoraciccavitydrainagetubeindwellingtimebetweenthetwogroups.Resultsthei

6、ndexoftwogroups'dataintheoperationtime,thenumberofthelymphnodescleaningandlengthofstaywassignificantdifferent(p<0.05);ThedifferenceoftheSingleincisiongroupandthetwoincisiongroupinthepostoperativecomplicationsaspectwasnotstatisiticallysignificant.ConclusionByomp

7、aringthetwogroups,wecanseethesingleincisiongrouphasshorteroperationtime,Smallerwound,fasterrecoveryandshorterhospitalizationtime.Thedoubleincisionsgrouphasadvantagesintheexposureoftheoperativefieldandthenumberofthelymphnodescleaning・Twogroupshavenosignificantdi

8、fferenceintheincidenceofperioperativecomplications・KeyWords:Lowerthoracicesophagealcarcinoma;Surgicalapproach;Leftthoracalsingleincision食管癌是一种常见的消化道多发肿瘤，开胸食管切除、区域淋巴结淸扫并消化道重建