中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
9期
835-837
,共3页
陈跃军%邹求益%朱广%汤轶%吴冠宇%刘哲亮%肖高明
陳躍軍%鄒求益%硃廣%湯軼%吳冠宇%劉哲亮%肖高明
진약군%추구익%주엄%탕질%오관우%류철량%초고명
食管肿瘤,胸段%淋巴结转移%手术入路%淋巴结清扫
食管腫瘤,胸段%淋巴結轉移%手術入路%淋巴結清掃
식관종류,흉단%림파결전이%수술입로%림파결청소
Esophageal neoplasms,thoracic%Lymph node metastasis%Surgical approach%Lymph node dissection
目的 探讨胸段食管癌淋巴结转移的规律和特点,从而为其手术入路和淋巴结清扫范围提供参考.方法 回顾性分析2009年1月至2012年12月间中南大学湘雅医学院附属肿瘤医院胸外科收治的72例胸段食管癌患者的临床资料,所有病例均行右胸入路手术.记录各组淋巴结的清扫及转移情况,并分析淋巴结转移的影响因素.结果 72例患者中,有48例出现淋巴结转移,淋巴结转移率为66.7％；清扫淋巴结总数为1495枚,转移181枚,淋巴结转移度为12.1％,平均每例清扫淋巴结20.8枚.在各组淋巴结中,右喉返神经旁(1R组)淋巴结转移率最高,达30.6％(22/72).左喉返神经旁淋巴结(2L组、4L组和5组)转移率为12.5％(9/72).淋巴结转移率与肿瘤大小和浸润深度有关(均P＜0.05),而与病变部位和分化程度无关(P＞0.05).结论 胸段食管癌淋巴结转移以右喉返神经旁淋巴结转移为主,故其手术最佳入路应是右胸入路,淋巴结清扫则应以右、左喉返神经旁淋巴结为重点的系统纵隔、腹野淋巴结清扫.
目的 探討胸段食管癌淋巴結轉移的規律和特點,從而為其手術入路和淋巴結清掃範圍提供參攷.方法 迴顧性分析2009年1月至2012年12月間中南大學湘雅醫學院附屬腫瘤醫院胸外科收治的72例胸段食管癌患者的臨床資料,所有病例均行右胸入路手術.記錄各組淋巴結的清掃及轉移情況,併分析淋巴結轉移的影響因素.結果 72例患者中,有48例齣現淋巴結轉移,淋巴結轉移率為66.7％；清掃淋巴結總數為1495枚,轉移181枚,淋巴結轉移度為12.1％,平均每例清掃淋巴結20.8枚.在各組淋巴結中,右喉返神經徬(1R組)淋巴結轉移率最高,達30.6％(22/72).左喉返神經徬淋巴結(2L組、4L組和5組)轉移率為12.5％(9/72).淋巴結轉移率與腫瘤大小和浸潤深度有關(均P＜0.05),而與病變部位和分化程度無關(P＞0.05).結論 胸段食管癌淋巴結轉移以右喉返神經徬淋巴結轉移為主,故其手術最佳入路應是右胸入路,淋巴結清掃則應以右、左喉返神經徬淋巴結為重點的繫統縱隔、腹野淋巴結清掃.
목적 탐토흉단식관암림파결전이적규률화특점,종이위기수술입로화림파결청소범위제공삼고.방법 회고성분석2009년1월지2012년12월간중남대학상아의학원부속종류의원흉외과수치적72례흉단식관암환자적림상자료,소유병례균행우흉입로수술.기록각조림파결적청소급전이정황,병분석림파결전이적영향인소.결과 72례환자중,유48례출현림파결전이,림파결전이솔위66.7％；청소림파결총수위1495매,전이181매,림파결전이도위12.1％,평균매례청소림파결20.8매.재각조림파결중,우후반신경방(1R조)림파결전이솔최고,체30.6％(22/72).좌후반신경방림파결(2L조、4L조화5조)전이솔위12.5％(9/72).림파결전이솔여종류대소화침윤심도유관(균P＜0.05),이여병변부위화분화정도무관(P＞0.05).결론 흉단식관암림파결전이이우후반신경방림파결전이위주,고기수술최가입로응시우흉입로,림파결청소칙응이우、좌후반신경방림파결위중점적계통종격、복야림파결청소.
Objective To explore the characteristics of lymph node metastasis in thoracic esophageal cancer in order to provide evidence for the extent of lymph node dissection and the operation access.Methods A retrospective study was performed on the specimens of 72 patients who underwent radical operation of right transthoracic approach and the features of lymph node metastasis were explored.Results Lymph node metastases were found in 48 of 72 patients (66.7％).In 1495 lymph nodes dissected,metastases was indentified in 181 lymph nodes (12.1％).The rate of lymph node metastasis in the right and left recurrent laryngeal nerve was 30.6％ and 12.5％ respectively.Lymph node metastasis was associated with tumor size and tumor invasion depth (both P ＜ 0.05),while tumor location and differentiation of tumor cells were not significant(both P ＞ 0.05).Conclusions The lymph node metastasis in thoracic esophageal carcinoma can be easily found in the right recurrent laryngeal nerve.The best surgical approach of thoracic esophageal carcinoma is the right transthoracic approach.
