【摘要】 背景与目的:食管切除局部区域淋巴清扫是胸下段食管癌的主要治疗手段。本研究旨在评价Ivor Lewis食管切除术二野淋巴清扫治疗胸下段食管癌的临床效果。方法:选择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胸下段食管鳞癌病例,观察清扫的淋巴结数目、术后并发症发生率、死亡率等指标,Kaplan-Meier法进行生存分析。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5例,Ⅱ期34例,Ⅲ期32例,Ⅳ期2例。总的5年生存率为23.3%。N0与N1病例5年生存率分别为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胸下段食管鳞癌是一项安全的手术,可增加完整切除(肉眼及镜下均无癌残留)机会。更多还原

【Abstract】 BACKGROUND & OBJECTIVE: Esophagectomy with local regional lymph node dissection is the main treatment for lower thoracic esophageal carcinoma. This study was to assess the clinical outcomes of Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus. METHODS: Clinical data of 73 patients with squamous cell carcinoma of the lower thoracic esophagus, who underwent Ivor Lewis esophagectomy with two-field lymph node dissection from Jan. 1998 to Dec. 2001, were analyzed retrospectively. Kaplan-Meier method was used for survival analysis. RESULTS: The morbidity of postoperative complications was 15.1% with a 2.7% mortality rate. The lymph node metastasis rate was 71.2%; the metastasis rate of the upper mediastinal nodes was 17.8%. Of the 73 patients, 5 were at stage Ⅰ, 35 at stage Ⅱ, 32 at stage Ⅲ, and 2 at stage Ⅳ. The overall 5-year survival rate was 23.3%. The 5-year survival rate was 38.1% for N0 patients and 17.3% for N1 patients (P<0.01), and was 31.2% for stage Ⅱa patients, 27.8% for stage Ⅱb patients, and 12.5% for stage Ⅲ patients (P<0.01). CONCLUSION: Ivor Lewis esophagectomy with two-field lymph node dissection for squamous cell carcinoma of the lower thoracic esophagus is a safe operation, and may increase the chances of complete resection.更多还原