CAJ | 학술논문

目的探讨胸段食管癌三野淋巴结清扫与传统术式在并发症发生率、死亡率、淋巴结清扫数量、淋巴结转移率和远期生存率等方面的差异,评价三野淋巴结清扫的优劣.方法同期入组的96例食管癌患者随机分成两组,46例行食管癌淋巴结三野清扫(三野清扫组),另外50例接受传统术式(传统手术组).结果三野清扫组扫除淋巴结39.28枚/例,显著高于传统手术组13.30枚/例(P<0.01);三野清扫组患者淋巴结阳性率73.91%(34/46),也明显高于传统手术组的38.00%(19/50);术后并发症发生率方面,喉返神经损伤和呼吸并发症三野清扫组显著高于传统手术组(P<0.05);三野清扫组术后胸腔积液引流量增多;三野清扫组3年生存率高于传统手术组(P<0.05).结论三野清扫术有效地扩大了淋巴结的清扫范围,使食管癌的分期更加准确,同时在提高患者生存率方面也有大量的证据.但缺点是手术创伤大,并发症的发生率较高.
목적 탐토흉단식관암삼야림파결청소여전통술식재병발증발생솔、사망솔、림파결청소수량、림파결전이솔화원기생존솔등방면적차이,평개삼야림파결청소적우렬.방법 동기입조적96례식관암환자수궤분성량조,46례행식관암림파결삼야청소(삼야청소조),령외50례접수전통술식(전통수술조).결과 삼야청소조소제림파결39.28매/례,현저고우전통수술조13.30매/례(P<0.01);삼야청소조환자림파결양성솔73.91%(34/46),야명현고우전통수술조적38.00%(19/50);술후병발증발생솔방면,후반신경손상화호흡병발증삼야청소조현저고우전통수술조(P<0.05);삼야청소조술후흉강적액인류량증다;삼야청소조3년생존솔고우전통수술조(P<0.05).결론 삼야청소술유효지확대료림파결적청소범위,사식관암적분기경가준학,동시재제고환자생존솔방면야유대량적증거.단결점시수술창상대,병발증적발생솔교고.
Objective To investigate the difference of complication incidence, death rate, quantity of lymphadeneetomy, lymphatic metastasis rate and long-term survival rate in thoracic squamons cell carcinoma of esophagus between three fields lymphadenectomy (3-FL) and traditional method. Methods Homoehronous 96 esophageal cancer patients were fractionated in two groups, 46 patients for 3-FL, the other 50 patients for traditional method. Results The average quantity of lymphadenectomy was 39.28 pieces per patient in 3-FL, and was significantly higher than 13.30 pieces per patient in traditional method (P <0.01). The rate of metastatic lymphatic nodes was 73.91%(34/46) in 3-FL patients, significantly higher than38.00%(19/50) in traditional method patients. For incidence of postoperative complications, recurrent laryngeal nerve damage and respiratory complication in 3-FL patients was significantly higher than patients in traditional method (P <0.05). The chest fluid obviously inereasod in 3-FL patients than in traditional method patients. There was significant contrast in 3-year survival rate between 3-FL patients and traditional method patients. Conclusion The there fields lymphadenectomy expand scope of lymphdenectomy effectually, accurate the staging of thoracic esophageal carcinoma. At the same time, a lot of evidence was found in raising survival rate for 3-FL. Disadvantage of 3-FL was severe surgical trauma, high incidence of complication, and a long recovery time after operation.