【作者】 吴捷； 柴； 周星明； 陈奇勋； 严福来；

【Author】 WU Jie,CHAI Ying,ZHOU Xing-ming, CHEN Qi-xun, YAN Fu-lai. Department of Thoracic Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009,China

【机构】 浙江大学医学院附属二院； 浙江省肿瘤医院胸腹外科；

【摘要】 目的评价Ivor lewis食管切除术二野淋巴结清扫治疗下胸段食管癌的临床效果。方法回顾性分析1998年1月至2001年12月73例行Ivor Lewis食管切除术二野淋巴清扫的下胸段食管鳞癌病例。结果术后并发症发生率15．1％,死亡率2．7％。淋巴结转移率71．2％,上纵隔淋巴转移率17．8％。I期病例5例,Ⅱ期病例35例,Ⅲ期病例32例,Ⅳ期病例2例。总5年生存率 23．3％。N(?)0与N(?)1病例5年生存率分别是38．1％与17．3％(P<0．01)。Ⅱa、Ⅱb、Ⅲ期病例的 5年生存率分别是31．2％、27．8％、12．5％(P<0．01)。结论 Ivor Lewis食管切除术二野淋巴清扫治疗下胸段食管鳞癌是一项安全的手术,可增加R0切除机会,提供更准确的分期,预后更好。更多还原

【Abstract】 Objective To assess the clinical outcomes of the Ivor Lewis esophagectomy with two - field lymph node dissectiom for squsmous cell carcinoma of the lower thoracic esophagus. Methods Seventy- three patients with squamous cell carcinoma of the lower thoracic esophagus who underwent Ivor Lewis esophagectomy with two - field lymph node dissection from January 1998 through December 2001 were retrospectively analyzed. Results The operative morbidity was 15. 1% with a 2. 7% mortality rate. The lymph node metastasis rate was 71.2% and that of upper me-diastinal nodal metastasis was 17. 8%. Postsurgical staging was as follows: stage I in five patients ,stageII in 35,stageIII in 32,and stageIV in 2. The overall 5 - year survival rate was 23. 3%. For N0 and N1 patients,the 5-year survival rate was 38. 1% and 17. 3%(P<0. 01)respectively. The 5-year survival rate for patients in stage II a, II b and III was 31. 2% ,27. 8% and 12. 5%(P< 0. 01) respectively. Conclusion Ivor Lewis esophagectomy with two -field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus is a safe operation. It increases the chances of obtaining R0 resection,and provides more accurate staging and better prognosis.更多还原