两种手术方式治疗下段食管癌临床研究分析

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1、两种手术方式治疗下段食管癌的临床研究分析高杨，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（p<0.05），单切口组和两切口组相

2、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TheclinicalresearchoftwokindsofoperationapproachtotreatthelowerthoracicesophagealcarcinomapatientsGaoYang，ZhouHaiying（Thoracics

3、urgeryofTangshanWorkers'HospitalofHeibeiProvince063000，China）Abstract：ObjectiveTocompareandevaluatethetwosurgicalapproaches,theleftthoracalsingleincisionandtherightthoracalandupperepigastrictwoincisionoperationtotreatthelower thoracicesophagealcarcinoma,soastoprovidethe

4、oreticalbasisfortheloweresophagealcancerclinicaloperationmodeselectionMethodstoreviewretrospectively235lower thoracicesophagealcarcinomacases.Todividethemintotheleftthoracicposteriorsingleincisiongroupandrightthoracicabdominalmediantwoincisiongroup.Tocomparetheclinicala

5、ndpathologicalindex:theoperativetime,thenumberofthelymphnodescleaning,theincidenceofpostoperativecomplications,upperesophagealpositivemarginrate,lengthofstayandthoraciccavitydrainagetubeindwellingtimebetweenthetwogroups.Resultstheindexoftwogroups’data in theoperationtim

6、e,thenumberofthelymphnodescleaningandlengthofstaywassignificantdifferent(p<0.05);ThedifferenceoftheSingleincisiongroupandthetwoincisiongroupinthepostoperativecomplicationsaspectwasnotstatisiticallysignificant.ConclusionByomparingthetwogroups,wecanseethesingleincisiongro

7、uphasshorteroperationtime,Smallerwound,fasterrecoveryandshorterhospitalizationtime.Thedoubleincisionsgrouphasadvantagesintheexposureoftheoperativefieldandthenumberofthelymphnodescleaning.Twogroupshavenosignificantdifferenceintheincidenceofperioperativecomplications.KeyW

8、ords: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