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目的:淋巴结的清扫影响食管癌术后进一步治疗决策制定以及预后评估。本文前瞻性研究两种食管癌术式总的淋巴结以及各区域淋巴结的清扫情况。方法 :随机选取2010年7月～2011年7月121例中下段食管癌的临床资料,分为IvorLewis术(41例)和左胸后外侧径路手术(80例)两组,比较总的淋巴结清扫数目、各区域淋巴结的清扫数目、淋巴结转移率与转移度、手术时间、出血量、术后胸腔引流量、术后住院天数、术后并发症发生率。结果:两种术式在上纵隔淋巴结清扫数目及转移率、手术时间、术中出血量方面的差异具有统计学意义(P<0.05);其余方面两组差异无统计学意义(P>0.05)。结论:Ivor Lewis术在上纵隔清扫方面具有明显优势,更能准确表达术后的病理分期,指导下一步治疗。
OBJECTIVE: Lymph node dissection affects the decision-making and prognosis of esophageal cancer after surgery. This prospective study of two kinds of total esophageal cancer lymph nodes and regional lymph node dissection. Methods: The clinical data of 121 middle and lower esophageal cancer from July 2010 to July 2011 were randomly divided into two groups: IvorLewis technique (41 cases) and left thoracotomy (80 cases). The total lymph node dissection The number of lymph nodes in each region, the lymph node metastasis rate and metastasis, operation time, blood loss, postoperative chest drainage, postoperative hospital stay, postoperative complications. Results: There were significant differences between the two methods in the number of lymph nodes dissection and the rate of metastasis, operation time and blood loss in operation (P <0.05). There was no significant difference between the two groups (P> 0.05) . Conclusion: Ivor Lewis operation has obvious advantages in upper mediastinum dissection, more accurate expression of postoperative pathological stage, guiding the next step of treatment.