摘要
目的探讨适合下胸段食管鳞癌的淋巴结清扫术。方法回顾2004年1月至2007年12月间浙江省肿瘤医院行二野淋巴结清扫术的300例下胸段食管鳞癌患者的临床资料。比较标准二野淋巴清扫术（标准二野组）与全二野淋巴清扫术（全二野组）的临床病理学特点、淋巴结切除情况、术后并发症及生存情况。结果全二野组清扫淋巴结（30±10）枚，多于标准二野组的（26±8）枚（t=3．510，P=0．001）。全二野组出现26例喉返神经损伤，呼吸衰竭率达5．1％，高于标准二野组的0．7％（x。=4．970，P=0．038）。全二野组的5年生存率为28．9％，标准二野组的5年生存率为30．2％，差异无统计学意义（x^2=0．006，P=0．936）。结论全二野淋巴清扫术不提高下胸段食管鳞癌的生存，增加术后并发症。局部晚期的下胸段食管鳞癌需考虑行选择性三野清扫和多学科综合治疗。
Objective To explore the suitable lymphadenectomy for squamous cell carcinoma of the lower thoracic esophagus. Methods From January 2004 to December 2007, 300 patients with lower thoracic esophageal squamous cell carcinoma underwent Ivor-Lewis esophagectomy with 2-field lymphadenectomy in our department. All cases were retrospectively analyzed. 143 cases underwent standardlymphadenectomy （standard group）, 157 cases underwent total lymphadenectomy（ total group）. The clinical and pathological characteristics, the status of lymph node metastases, postoperative complications and survival rates were compared between two groups. Results There were more lymph nodes dissected （ 30 ±10 vs 26 ±8, P =0. 001 ） and higher respiratory failure rate （ 16. 6% vs 0. 7% , P = 0. 038 ） in total group than in standard group. The 5-year survival rate was 28.9% and 30. 2%, respectively（P =0. 936）. Conclusion The total 2-field lymphadenectomydoesn＇t provides better survival benefit for patients with squamous cell carcinoma of the lower thoracic esophagus, instead more complications occurred. For local advanced tumor, 3-field lymphadenectomy and comprehensive treatment should be considered.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第41期3297-3299,共3页
National Medical Journal of China
关键词
食管肿瘤
癌
鳞状细胞
淋巴结切除术
Esophageal neoplasms
Carcinoma, squamous cell
Lymph node excision
