【摘要】 目的比较经左颈胸二切口术与经右颈胸腹三切口术治疗食管癌的疗效。方法选择2009年10月至2013年10月间收治的46例食管癌患者作为观察组,选取同期收治的52例食管癌患者作为对照组,观察组给予经左颈胸二切口术治疗,对照组给予经右颈胸腹三切口术治疗,对比分析两组患者治疗后手术并发症发生率、手术期病死率、1年生存率、3年生存率和5年生存率以及生活质量。结果观察组并发症发生率和围手术期死亡率分别为15.2%和2.2%,明显低于对照组的36.5%和15.4%,差异有统计学意义(P<0.05)。观察组患者1年生存率、3年生存率与对照组比较,差异无统计学意义(P>0.05);5年生存率明显高于对照组(P<0.05)。观察组患者进餐后胸闷不适感和体重下降发生率明显低于对照组,差异有统计学意义(P<0.05)。两组患者食欲不振、吞咽困难、腹泻、反酸发生率比较,差异无统计学意义(P>0.05)。结论与经右颈胸腹三切口术比较,经左颈胸二切口术治疗食管癌能有效降低患者手术并发症发生率、围手术期死亡率、进餐后胸闷不适感、体重下降发生率,提高5年生存率,效果较为理想,具有很好的临床应用推广价值。更多还原

【Abstract】 Objective To find better surgical method by comparing the therapeutic efficacy of 2-incisions through left thoracic-cervical pathway and 3-incision through rignt thoracic-cervical pathway in the treatment of esophageal cancer.Methods Forty-six cases of esophageal cancer patients from October 2009 to October 2013 treated in the hospital were collected as the observation group,and other 52 patients in control group who came from the same period in the hospital.Patients of the observation group received 2-incisions through left thoracic-cervical pathway,patients in the control group operated through rignt thoracic-cervical pathway 3-incision.The operative mortality,1-year,3-year and 5-year survival rate of survival and quality of life in two groups were comparated and analysed after treatment.Results The rate of complications and preoperative mortality in observation group were 15.2% and 2.2%,significantly lower than the control group(36.5% and 15.4%),the differences were statistically significant(P < 0.05).1-year survival rate,3-year survival rate of observation group compared with the control group,there were no statistically significant differences(P > 0.05);The 5-year survival rate was significantly higher than the control group(P < 0.05).Chest discomfort after eating and weight loss rate in observation group were significantly lower than the control group,the difference was statistically significant(P < 0.05);loss of appetite between the two groups(P > 0.05).Conclusions Comparing with 3-incision through right thoracic-cervical pathway,2-incision esophagectomy via left thoracic-cervical pathway in treatment of esophageal cancer can effectively reduce the incidence of complications,perioperative mortality,5-year survival rate,incidence of chest discomfort after eating,weight loss in patients with esophagus carcinoma.It has great value in clinical application promotion.更多还原