CAJ | 학술논문

目的探讨食管癌手术中淋巴结清扫枚数及组数与术后并发症的关系.方法回顾性总结2008年1月至2009年12月间四川大学华西医院收治的794例行食管癌根治性手术患者的临床病理资料,分析食管癌术后并发症的危险因素.结果全组无手术死亡病例,有84例(10.6％)患者出现术后并发症.全组共清扫11 770枚淋巴结,平均每例14.8枚.多因素逻辑回归分析显示,患者性别、淋巴结转移数目、吻合部位与手术医生技能水平是食管癌术后并发症的影响因素(均P＜0.05),而淋巴结清扫枚数及组数对于术后并发症发生率并无显著影响(均P＞0.05).结论食管癌术后并发症的发生率与一定范围内淋巴结清扫数(小于50枚)及组数的增加无关,应尽可能广泛地清扫食管区域淋巴结.
목적 탐토식관암수술중림파결청소매수급조수여술후병발증적관계.방법 회고성총결2008년1월지2009년12월간사천대학화서의원수치적794례행식관암근치성수술환자적림상병리자료,분석식관암술후병발증적위험인소.결과 전조무수술사망병례,유84례(10.6％)환자출현술후병발증.전조공청소11 770매림파결,평균매례14.8매.다인소라집회귀분석현시,환자성별、림파결전이수목、문합부위여수술의생기능수평시식관암술후병발증적영향인소(균P＜0.05),이림파결청소매수급조수대우술후병발증발생솔병무현저영향(균P＞0.05).결론 식관암술후병발증적발생솔여일정범위내림파결청소수(소우50매)급조수적증가무관,응진가능엄범지청소식관구역림파결.
Objective To investigate the association between the number of lymph nodes retrieval and the incidence of postoperative complications in patients with esophageal carcinoma.Method From January 2008 to December 2009,794.patients with esophageal carcinoma underwent esophagectomy and lymphadenectomy in the Department of Thoracic Surgery at the West China Hospital of Sichuan University.The clinical data,surgeons,the extent of lymphadenectomy and its association with operative mobidity were retrospectively analyzed.Results There was no operative death.A total of 84 patients with complication(10.6％) were documented.There were 11,770 lymph nodes harvested in total with an average of 14.8.Multivariate logistic regression showed that gender, number of metastatic lymph nodes,level of anastomosis,and surgeons' experience were risk factors associated with postoperative complications (all P＜0.05),while the number and group of lymph node resection were not (all P＞0.05).Conclusion Within a rational range of lymphadenectomy ( ＜ 50) following esophagectomy,the postoperative complications are significantly associated with the gender,extent of regional lymph nodes metastasis, site of anastomosis and the expertise of the surgeons, but not associated with the number and group of lymph nodes resection.