AIM： To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus. METHODS： From January 1998 to Dece...AIM： To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus. METHODS： From January 1998 to December 2001, 73 patients with lower thoracic esophageal carcinoma underwent Ivor-Lewis subtotal esophagectomy with two-field lymphadenectomy. Clinicopathological information, postoperative complications, mortality and long term survival of all these patients were analyzed retrospectively. RESULTS： The operative morbidity and mortality was 15.1% and the mortality was 2.7%. Lymph node metastases were found in 52 patients （71.2%）. Nodal metastases to the upper, middle, lower mediastini and upper abdomen were found in 13 （17.8%）, 15 （20.5%）, 30 （41.1%）, and 25 （34.2%） patients, respectively. Postoperative staging was as follows： stage Ⅰ in 5 patients, stage Ⅱ in 34 patients, stage Ⅲ in 32 patients, and stage Ⅳ in 2 patients, respectively. The overall 5-year survival rate was 23.3%. For NO and N1 patients, the 5-year survival rate was 38.1% and 17.3%, respectively （X^2 = 22.65, P 〈 0.01）. The 5-year survival rate for patients in stages Ⅱ a, Ⅱ b and Ⅲ was 31.2%, 27.8% and 12.5%, repsectively （X^2 = 29.18, P 〈 0.01）. CONCLUSION： Ivor Lewis subtotal esophagectomy with two-field （total mediastinum） lymphadenectomy is a safe and appropriate operation for squamous cell carcinoma of the lower thoracic esophagus.展开更多
目的探讨二野淋巴结清扫术(2-FL)与三野淋巴结清扫术(3-FL)在食管癌患者中的疗效及预后。方法检索中国知网、万方数据库、维普、Web of Science、Cochrane library、PubMed等,收集2-FL与3-FL运用在食管癌根治术中的随机对照试验(RCT)及...目的探讨二野淋巴结清扫术(2-FL)与三野淋巴结清扫术(3-FL)在食管癌患者中的疗效及预后。方法检索中国知网、万方数据库、维普、Web of Science、Cochrane library、PubMed等,收集2-FL与3-FL运用在食管癌根治术中的随机对照试验(RCT)及倾向性评分匹配研究(PSM),检索时限为自建库至2023年12月,对符合纳入标准的文献行数据提取和质量评价后行meta分析。结果共纳入10篇文献,包括6篇RCT,4篇PSM。共纳入2180例研究对象。meta分析结果显示,3-FL组较2-FL组手术时间长,差异有统计学意义(P<0.05),但术中出血量差异无统计学意义(P>0.05)。3-FL组淋巴结清扫数量及获得阳性淋巴结数量多于2-FL组,差异有统计学意义(P<0.05)。在术后心脏并发症、呼吸系统并发症、乳糜胸、吻合口瘘、喉返神经损伤方面,3-FL组与2-FL组差异无统计学意义(P>0.05)。两组生存率和无病生存期差异无统计学意义(P>0.05)。结论在食管癌患者中行3-FL术后生存率与2-FL相当,不会增加术后并发症,且3-FL可获得更多阳性淋巴结,可以提高肿瘤分期的准确性,值得临床推广应用。展开更多
文摘AIM： To evaluate the clinical outcome of Ivor Lewis subtotal esophagectomy with two-field lymphadenectomy for patients with squamous cell carcinoma of the lower thoracic esophagus. METHODS： From January 1998 to December 2001, 73 patients with lower thoracic esophageal carcinoma underwent Ivor-Lewis subtotal esophagectomy with two-field lymphadenectomy. Clinicopathological information, postoperative complications, mortality and long term survival of all these patients were analyzed retrospectively. RESULTS： The operative morbidity and mortality was 15.1% and the mortality was 2.7%. Lymph node metastases were found in 52 patients （71.2%）. Nodal metastases to the upper, middle, lower mediastini and upper abdomen were found in 13 （17.8%）, 15 （20.5%）, 30 （41.1%）, and 25 （34.2%） patients, respectively. Postoperative staging was as follows： stage Ⅰ in 5 patients, stage Ⅱ in 34 patients, stage Ⅲ in 32 patients, and stage Ⅳ in 2 patients, respectively. The overall 5-year survival rate was 23.3%. For NO and N1 patients, the 5-year survival rate was 38.1% and 17.3%, respectively （X^2 = 22.65, P 〈 0.01）. The 5-year survival rate for patients in stages Ⅱ a, Ⅱ b and Ⅲ was 31.2%, 27.8% and 12.5%, repsectively （X^2 = 29.18, P 〈 0.01）. CONCLUSION： Ivor Lewis subtotal esophagectomy with two-field （total mediastinum） lymphadenectomy is a safe and appropriate operation for squamous cell carcinoma of the lower thoracic esophagus.
文摘目的探讨二野淋巴结清扫术(2-FL)与三野淋巴结清扫术(3-FL)在食管癌患者中的疗效及预后。方法检索中国知网、万方数据库、维普、Web of Science、Cochrane library、PubMed等,收集2-FL与3-FL运用在食管癌根治术中的随机对照试验(RCT)及倾向性评分匹配研究(PSM),检索时限为自建库至2023年12月,对符合纳入标准的文献行数据提取和质量评价后行meta分析。结果共纳入10篇文献,包括6篇RCT,4篇PSM。共纳入2180例研究对象。meta分析结果显示,3-FL组较2-FL组手术时间长,差异有统计学意义(P<0.05),但术中出血量差异无统计学意义(P>0.05)。3-FL组淋巴结清扫数量及获得阳性淋巴结数量多于2-FL组,差异有统计学意义(P<0.05)。在术后心脏并发症、呼吸系统并发症、乳糜胸、吻合口瘘、喉返神经损伤方面,3-FL组与2-FL组差异无统计学意义(P>0.05)。两组生存率和无病生存期差异无统计学意义(P>0.05)。结论在食管癌患者中行3-FL术后生存率与2-FL相当,不会增加术后并发症,且3-FL可获得更多阳性淋巴结,可以提高肿瘤分期的准确性,值得临床推广应用。
