��ͬ������·���¶�ʳ�ܰ��ܰͽ���ɨ���ٴ�Ӧ���о�

目的 比较经胸、经左胸腹行下段食管癌根治手术的优缺点,探讨淋巴结清扫的最佳手术径路.方法 回顾性分析2000年1月至2005年1月中山大学附属第一医院心胸外科经胸(96例)和胃肠外科经左胸腹入路(117例)行下段食管癌根治术的临床资料,比较二组的胸、腹淋巴结清扫数、各区域淋巴结转移度、手术时间、出血量、围手术期死亡率、术后并发症发生率、术后平均恢复时间、生存率.结果 经左胸腹组和经胸组在上纵隔及No.1、2、3、4和No.7、8、9、11的淋巴结转移度比较,二组差异有统计学意义(P＜0.05);围手术期死亡率、手术时间、出血量、并发症发生率、术后平均恢复时间、生存率,二组比较差异均无统计学意义(P＞0.05).结论 下段食管癌根治术经胸入路对上纵隔淋巴结清扫有优势,而经左胸腹入路对腹腔淋巴结清扫有优势.

Clinical research of different surgical approaches for lymphadenectomy in radical esophagectomy

??Objective:To compare 2 surgical approaches for radical esophagectomy and discuss which is a better operative pathway of lymphadenectomy. Methods:Clinical data of 96 patients of thoracic incision and 117 of left abdomino??thoracic incision with squamous cell carcinoma of the lower esophagus, who underwent radical esophagectomy from Jan 2000 to Jan 2005 in the first affiliated hospital of Sun Yet??san Universtiy,were analyzed retrospectively. Compared was made on number of lymph node resected, regional lymph node metastasis ratio,perioperative mortality,operation time,bleeding volume,surgical complication rate,postoperative hospital stay,median survival period between the 2 groups. Results:There was significant difference in superior mediastinum,and lymph node of the 1st,2nd group abdomen between 2 groups (P<0.05),but there were no significant difference between 2 groups (P>0.05) in the perioperative mortality,operation time,bleeding volume,surgical complication rate,postoperative hospital days,survival rate. Conclusion:Left thoracic incision is more effective on lymphadenectomy of superior mediastinum,Whereas abdomino??thoracic incision shows more effective on lymphadenectomy of abdominal region.