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目的探讨治疗食管癌的理想手术切口。方法回顾性收集在我科采用腋下横切口治疗食管癌患者212例(TT组),并与同期采用传统后外侧切口治疗食管癌317例患者(PLT组)的临床资料进行对比分析。结果 TT组高龄患者比例高,术前有伴发病患者居多,术后1个月肩部功能恢复及3年生存率比例高(P<0.05),PLT组肿瘤浸润深、病理分期晚(P<0.01),术后1个月切口慢性疼痛比例高(P<0.05)。两组手术时间、根治性手术比例、术后并发症及术后1年生存率无统计学意义(P>0.05)。结论腋下横切口治疗食管癌创伤小,术后恢复快,可作为食管癌手术常规和首选的探查切口。必要时可随即中转后外侧切口完成根治性手术。
Objective To investigate the ideal surgical incision for the treatment of esophageal cancer. Methods We retrospectively collected 212 cases of esophageal cancer (TT group) treated with axillary transverse incision in our department and compared with the clinical data of 317 cases of esophageal cancer (PLT group) treated with conventional posterolateral incision in the same period. Results The proportion of elderly patients in TT group was higher than that in patients with preoperative and postoperative complications. The functional recovery of shoulder and the 3-year survival rate were higher in 1 month after operation (P <0.05). The tumors in PLT group were deeply infiltrated and the pathological stage was late (P < 0.01). One month after operation, the proportion of chronic pain in incision was high (P <0.05). There was no significant difference in the operation time, the proportion of radical surgery, postoperative complications and 1-year survival rate after operation (P> 0.05). Conclusion Axillary transverse incision for the treatment of esophageal cancer trauma, fast recovery, can be used as esophageal cancer surgical routine and the preferred exploration incision. Necessary, then after the transfer of the lateral incision to complete radical surgery.