摘要
目的比较胸段食管鳞癌经左右胸入路胸腹二野淋巴结清扫结果的差异。方法收集2010年1月至2016年3月于南京鼓楼医院集团仪征医院胸外科手术的313例胸段食管鳞癌患者的临床资料(其中左胸传统二野淋巴结清扫175例,右胸现代二野淋巴结清扫138例),对不同入路淋巴结清扫结果进行回顾性分析。结果左右胸入路平均清扫淋巴结数分别为15.8枚和23.7枚(P<0.05),两组总淋巴结转移率分别为36.0%、47.8%(P<0.05)。上纵隔淋巴结转移率分别为4.8%、26.8%(P<0.05);中下纵隔淋巴结转移率分别为22.9%、24.6%(P>0.05);腹部淋巴结转移率分别为24.6%、26.1%(P>0.05)。结论右胸入路现代二野淋巴结清扫能较好地清扫上纵隔及腹腔淋巴结,是胸段食管鳞癌较为理想的手术入路和淋巴结清扫方式。
Objective To compare the results of thoraco-abdominal two-field lymph node dissection in thoracic esophageal squamous carcinoma via left versus right thoracotomy.Methods A total of 313 patients with thoracic esophageal squamous carcinoma were selected in Yizheng Hospital of Drum Tower Hospital Group of Nanjing from January 2010 to March 2016,including 175 cases through left thoracotomy and 138 cases through right thoracotomy.The results of lymph nodes dissection were retrospectively analyzed.Results The average number of dissected lymph nodes from left thoracotomy and right thoracotomy were 15.8 and 23.7,respectively（P〈0.05）.The overall lymph node metastasis rate was 36.0% via left thoracotomy and 47.8% via right thoracotomy（P〈0.05）,and 4.8% vs 26.8% in the superior mediastinum（P〈0.05）,and 22.9% vs 22.6% in the middle/inferior mediastinum（P〉0.05）,and 24.6% vs 26.1% in the abdomen（P〉0.05）.The lymph node metastasis rate had no significant difference between the two groups in the same T stage,the same tumor location,and the same tumor differentiation degree.Conclusions Modern thoraco-abdominal two-field lymph node dissection through right thoracotomy with the superiority in cleaning superior mediastinal and abdominal lymph nodes,is an ideal surgical approach and lymph node dissection for thoracic esophageal squamous carcinoma.
出处
《齐齐哈尔医学院学报》
2016年第36期4492-4495,共4页
Journal of Qiqihar Medical University
关键词
食管癌
二野淋巴结清扫
Esophageal carcinoma
Two-field lymph node dissection
