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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (1): 67-72.doi: 10.6040/j.issn.1671-7554.0.2014.078

• 临床医学 • 上一篇    下一篇

两种手术路径治疗胸中段食管癌疗效比较

马洪海, 杜贾军   

  1. 山东大学附属省立医院胸外科, 山东 济南 250021
  • 收稿日期:2014-02-19 修回日期:2014-12-17 发布日期:2015-01-10
  • 通讯作者: 杜贾军。E-mail:dujiajun@sdu.edu.cn E-mail:dujiajun@sdu.edu.cn
  • 基金资助:
    山东省科技发展计划(2012GG0021836)

Comparison of treatment outcomes after two different surgical approaches for operable middle thoracic esophageal squamous cell carcinoma

MA Honghai, DU Jiajun   

  1. Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2014-02-19 Revised:2014-12-17 Published:2015-01-10

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摘要： 目的 回顾性分析两种不同手术路径治疗胸中段食管癌的疗效。方法 研究纳入107例胸中段食管癌患者,根据手术路径不同分为两组:左胸入路组和Ivor-lewis组。采用Kaplan-Meier曲线和COX回归分析比较两组患者的生存差异,并用方差分析和非参数检验比较术后并发症、淋巴结切除情况以及其他临床因素在两组间的差异。结果 患者的一般特征、总体生存时间(P=0.315)、无复发生存时间(P=0.246)、术后胸腔总引流量(P=0.241)、淋巴结切除个数(P=0.065)、阳性淋巴结个数(P=0.188)等在两组间均无统计学差异。左胸入路组患者失血量显著少于Ivor-lewis组(P=0.007),手术时间也明显较短(P=0.042)。COX回归分析显示,T分期(P=0.001)、N分期(P=0.007)和转移淋巴结率(MLR,P=0.040)均为预后的独立危险因素。结论 Ivor-lewis和左胸入路均为胸中段食管癌手术的可选路径。

关键词: 食管鳞癌, 食管切除术, 淋巴结清扫

Abstract: Objective To compare the efficacy of two different surgical routes for operable esophageal squamous cell carcinoma (ESCC). Methods A total of 107 patients with middle thoracic ESCC were enrolled and divided into two groups: left transthoracic approach group and Ivor-lewis approach group. Cox regression analysis and Kaplan-Meier curves were used to explore the difference of survival in the two groups. Postoperative complications, information on lymph node dissection and other clinical factors were compared using non-parametric test and Chi-Square test. Results There were no significant differences between the two groups in the patients' characteristics, overall survival (P=0.315), recurrence-free survival (P=0.246), chest drainage volume (P=0.241), number of resected (P=0.065) and positive lymph nodes (P=0.188). However, blood loss (P=0.007) and operation time (P=0.042) were significantly less or shorter in left transthoracic approach group. T status (P=0.001), N status (P=0.007), as well as metastatic lymph node ratio (MLR, P=0.040), were shown as independent prognostic risk factors by COX regression analysis. Conclusion Both Ivor-Lewis approach and left transthoracic approach are optional surgical routes for operable middle thoracic ESCC.

Key words: Lymph node excision, Esophageal squamous cell carcinoma, Esophagectomy

中图分类号: 

  • R655.4
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