Abstract:Objective: To analyze the effect of different operative approaches on lymph node dissection and treatment of esophageal cancer patients. Methods: 90 patients with esophageal cancer admitted to our hospital from May 2016 to May 2018 were retrospectively studied. According to the different surgical approaches, the two groups were divided into two groups: group A was treated with lvor-Lewis operation, while group B was treated with left chest operation. The number of abdominal and thoracic lymph node dissection and the incidence of complications were compared between the two groups. Results: The metastatic rate of upper mediastinal lymph nodes in group A was 24.00%, which was significantly higher than that in group B 10.00%(χ2=6.945,P<0.05), and that in group A was 20.00%, which was significantly higher than that in group B (χ2=7.495,P<0.05). There was no significant difference in lymph node metastasis between the lower mediastinum and abdominal region between the two groups (P>0.05). The incidence of arrhythmia, anastomotic stenosis, delayed gastric emptying, anastomotic fistula and chest infection were not significantly different between the two groups (all P>0.05). ). Conclusion: Compared with the left thoracic approach, lvor-Lewis two-field dissection is more thorough and effective in the treatment of metastatic lymph nodes in patients with esophageal cancer, which is worthy of wide clinical application.
马生茂, 党继芳, 张华, 吕军其, 陈永祥, 马伟林. 不同手术入路对食管癌切除患者的淋巴结清扫及治疗效果影响[J]. 河北医学, 2019, 25(3): 664-666.
MA Shengmao, et al. Effect of Different Operative Approaches on Lymph Node Dissection and treatment of Patients with Esophageal Carcinoma. HeBei Med, 2019, 25(3): 664-666.
[1] 鄂德琇,冶治,高哲俊,等.胸腔镜与传统手术对食管癌的临床疗效与术后体液及细胞免疫功能的影响[J].河北医学,2017,23(9):1433~1437. [2] Nowicki A, Dahms S. Incidence, morbidity and 5-year survival of colorectal cancer patients in the Kujawsko-Pomorskie voivodship in 2005-2011, based on data from the National Health Fund[J]. Pol Przegl Chir, 2018,90(4):1~8. [3] 林栋,叶挺,马龙飞,等.胸段食管鳞癌二野与三野淋巴结清扫术的疗效比较[J].中华胃肠外科杂志,2016,19(9):990~994. [4] Yoshida Y, Komori K, Aoki M, et al. Efficacy of pegfilgrastim administration in patients with esophageal cancer treated with docetaxel, cisplatin, and 5-fluorouracil[J]. Pharmazie, 2018,73(10):613~616. [5] Shimada A, Takeuchi H, Fukuda K, et al. Hyponatremia in patients with esophageal cancer treated with chemotherapy including cisplatin[J]. Esophagus, 2018,15(4):209~216. [6] Kawamoto T, Nihei K, Sasai K, et al. Involved-field chemoradiotherapy for postoperative solitary lymph node recurrence of esophageal cancer[J]. Esophagus, 2018,15(4):256~262. [7] Koyanagi K, Kato F, Nakanishi K, et al. Lateral thermal spread and recurrent laryngeal nerve paralysis after minimally invasive esophagectomy in bipolar vessel sealing and ultrasonic energy devices: a comparative study[J]. Esophagus, 2018,15(4):249~255. [8] Tanaka Y, Ueno T, Yoshida N, et al. The effect of an elemental diet on oral mucositis of esophageal cancer patients treated with DCF chemotherapy: a multi-center prospective feasibility study (EPOC study)[J]. Esophagus, 2018,15(4):239~248. [9] 彭雄,陈云,Abdillah Nassor Juma,等.微创McKeown食管癌根治术与Ivor-Lewis手术治疗食管癌的近期疗效对比[J].中南大学学报(医学版),2017,42(5):546~552. [10] Wang X, Wang JZ, Li JB, et al. Changes in cardiac volume determined with repeated enhanced 4DCT during chemoradiotherapy for esophageal cancer[J]. Radiat Oncol, 2018,13(1):181. [11] Cheng B, Chen X, Li Y, et al. Prognostic value of monocarboxylate transporter 4 in patients with esophageal squamous cell carcinoma[J]. Oncol Rep, 2018,40(5):2906~2915.