摘要
目的探讨全腔镜下二野与三野淋巴结清扫术在食管癌中的应用效果。方法选取230例食管癌患者,根据不同的治疗方法,将230例患者分为二野组(n=120)和三野组(n=110)。二野组接受全腔镜二野淋巴结清扫术,三野组接受全腔镜三野组淋巴结清扫术。比较两组患者淋巴结切除及转移情况、并发症发生率、1年生存率及复发率。结果二野组平均每个患者淋巴结清扫数[(16.02±4.72)枚]显著低于三野组[(23.22±5.41)枚],二野组淋巴结转移率(59.2%)显著高于三野组(41.8%)(P<0.05)。两组淋巴结转移度无统计学差异(P>0.05)。三野组喉返神经损伤、呼吸系统并发症、吻合口瘘及心血管并发症发生率均显著高于二野组(P<0.05)。二野组患者1年生存率(83.3%)显著低于三野组(95.5%),二野组1年颈部淋巴结复发率和纵膈淋巴结复发率均明显高于三野组,差异均有统计学意义(P<0.05)。结论全腔镜下三野淋巴结清扫术有利于提高食管癌的根治性,且有效降低术后转移率和复发率,提高患者的生存率,值得在临床推广。
Objective To investigate application of total laparoscopic 2-field lymph adenectomy node dissection and 3- field lymphadenectomy in the treatment of esophageal carcinoma. Methods 230 patients with esophageal carcinoma were selected. According to the different treatment methods ,230 patients were divided into 2-field group （ n = 120 ） and 3-field group （ n = 110）. The 2-field group received endoscopic 2-field lymph node dissection,3-field group received total laparoscopic 3-field lymph node dissection. The lymph node resection and metastasis, complications, 1-year survival rate and recurrence rate were compared between the 2 groups. Results The lymph nodes per patient of 2-field group （ 16.02 ± 4.72 ） was significantly lower than the 3- field group （23.22 ± 5.41 ） （P 〈 0.05）. The lymph node metastasis rate （59.2%） of 2-field group was significantly higher than that of the 3-field group （41.8%） （P 〈 0.05 ）. There was no significant difference in lymph node metastasis between the 2 groups （P 〉 0.05 ）. Recurrent laryngeal nerve injury, respiratory complications, anastomotic fistula and cardiovascular complications of 3- field were significantly higher than that of the second field army group （ P 〈 0.05 ）. 1 -year survival rate of 2-field group （ 83.3% ） was significantly lower than that of 3-fieldgroup （95.5%）. The recurrence rate of cervical lymph nodes and mediastinal lymph nodes of 2-field were significantly higher than that of 3-field group （ P 〈 0.05 ）. Conclusion Total laparoscopic 2-field and 3- field lymph adenectomy node dissection can improve the esophageal cancer radical, and effectively reduce the rate of postoperative recurrence and metastasis rate, improve the survival rate of patients, it is worthy of clinical application.
出处
《实用癌症杂志》
2017年第5期847-849,852,共4页
The Practical Journal of Cancer
关键词
二野淋巴结清扫术
三野淋巴结清扫术
食管癌
2-field lymph node dissection
3-field lymph node dissection
Esophageal carcinoma
