经颈、经食管裂孔食管切除术对食管癌患者的疗效分析

尹哲; 王志强; 陈琪; 蔡华荣

doi:10.16016/j.2097-0927.202112080

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经颈、经食管裂孔食管切除术对食管癌患者的疗效分析

临床医学 | 更新时间：2026-01-09

- 经颈、经食管裂孔食管切除术对食管癌患者的疗效分析
- Efficacy of trans-cervical and trans-hiatal esophagectomy for esophageal carcinoma
- 陆军军医大学学报 2022年44卷第18期页码：1867-1873
- 作者机构：
  
  400030 重庆, 重庆大学附属肿瘤医院胸外科
- 作者简介：
  
  [ 蔡华荣，E-mail: 18555203@qq.com CAI Huarong, E-mail: 18555203@qq.com
- 基金信息：
  
  重庆市技术创新与应用发展专项面上项目(cstc2020jscx-msxmX0283)
- DOI：10.16016/j.2097-0927.202112080
  中图分类号： R181.32;R730.56;R735.1
- 收稿：2021-12-10，
  
  修回：2022-05-09，
  
  纸质出版：2022-09-30
- 稿件说明：
移动端阅览
尹哲, 王志强, 陈琪, 等. 经颈、经食管裂孔食管切除术对食管癌患者的疗效分析[J]. 陆军军医大学学报, 2022,44(18):1867-1873.

Zhe YIN, Zhiqiang WANG, Qi CHEN, et al. Efficacy of trans-cervical and trans-hiatal esophagectomy for esophageal carcinoma[J]. Journal of Army Medical University, 2022, 44(18): 1867-1873.
尹哲, 王志强, 陈琪, 等. 经颈、经食管裂孔食管切除术对食管癌患者的疗效分析[J]. 陆军军医大学学报, 2022,44(18):1867-1873. DOI： 10.16016/j.2097-0927.202112080.

Zhe YIN, Zhiqiang WANG, Qi CHEN, et al. Efficacy of trans-cervical and trans-hiatal esophagectomy for esophageal carcinoma[J]. Journal of Army Medical University, 2022, 44(18): 1867-1873. DOI： 10.16016/j.2097-0927.202112080.

摘要

目的

评估经颈、经食管裂孔食管切除术与胸腔镜食管切除术治疗食管癌患者的效果。

方法

选取重庆大学附属肿瘤医院2018年9月至2020年10月接受治疗的食管癌患者80例，采用简单随机分组的方法分为观察组和对照组。观察组40例接受经颈、经食管裂孔食管切除术，对照组40例接受胸腔镜食管切除术。比较两组患者术中出血、清扫纵隔淋巴结总数、手术时间、左或右侧喉返神经旁淋巴结清扫数量、入住ICU时间、术后疼痛评分、术后住院时间、PO

/FIO

、术后肺部感染和淋巴结转移等情况。

结果

80例患者均顺利完成手术。结果显示，观察组的手术时间少于对照组(200 min

235 min，

=-3.700

0.001)。观察组的左侧喉返神经旁淋巴结清扫数量多于对照组(25.0%

2.5%

=2.568

=0.010)。两组术后第1天(0%

17.5%

=-4.292

0.001)和第3天(12.5%

37.5%

=-3.363

0.001)疼痛评分、术后48 h PO

/FIO

(290 min

255 min

=3.747

0.001)、住院时间(7 d

8 d

=-2.119

=0.034)、并发肺部感染率(

=4.114

=0.043)差异均有统计学意义。

结论

经颈、经食管裂孔切除术是治疗食管癌患者一种较好的手术方式，可为不能行开胸手术的患者提供治疗机会。

Abstract

Objective

To assess the efficacy of the trans-cervical and trans-hiatal esophagectomy versus thoracoscopic esophagectomy in patients with esophageal carcinoma.

Methods

A total of 80 esophageal carcinoma patients undergoing surgical treatment in

our hospital from September 2018 to October 2020 were enrolled in this study

and they were divided into observation group (

=40) and control group (

=40). The patients out of the observation group underwent the trans-cervical and trans-hiatal esophagectomy

and those from the control group underwent the thoracoscopic esophagectomy. The preoperative

intraoperative and postoperative data were analyzed between the 2 groups

regarding intraoperative blood loss

number of dissected mediastinal lymph nodes

operation time

number of lymph nodes in left para-recurrent laryngeal nerve (para-RLN) or right para-RLN

length of staying in intensive care unit (ICU)

postoperative pain score

length of postoperative stay

/fraction of inspiration O

(PO

/FIO

)

pulmonary infection

and lymphatic metastasis.

Results

The operation was successfully performed in all 80 patients. The patients in the observation group had shorter operation time (200

235 min

Z=-3.700

0.001) and larger number of dissected mediastinal lymph nodes in left para-RLN (25.0%

2.5%

=2.568

=0.010) than those in the control group. Significant differences were observed in the pain scores of postoperative day 1 (0%

17.5%

=-4.292

0.001) and day 3 (12.5%

37.5%

=-3.363

0.001)

postoperative 48-h PO

/FIO

(290

255 min

=3.747

0.001)

length of postoperative stay (7 d

8 d

=-2.119

=0.034)

and incidence of postoperative pulmonary infection (

=4.114

=0.043) between the 2 groups.

Conclusion

Trans-cervical and trans-cervical esophagectomy is a good approach in treatment of esophageal carcinoma

and may provide an option to the patients who cannot suffer from the thoracotomy.

关键词

Keywords

references

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