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食管癌患者相对5年生存率在过去的30年中得到了提高,这可能与手术技术提高、系统放化疗方案改进以及综合治疗不断被接受等因素有关。手术治疗目前仍然是食管癌主要治疗方案的组成部分。食管癌的多种手术方案可以归为经胸入路、经膈肌入路手术两类,主要矛盾在于经胸手术手术切除更广泛,与并发症和死亡率较少的经膈手术相比是否能达到更好的预后。先前已有大量关于这些争议的验证,结论是这两种手术的任一种方案都没有证实优于另一种,在经验丰富的术者操作下患者均取得了良好的短期效果。有关文献还提示,术者经验以及医院食管癌手术管理经验是手术并发症及死亡率重要影响因素,前者可能超过了不同手术方案的选择所产生的影响。经胸、经膈肌两种手术方案的手术结果相似。
The relative 5-year survival rate of esophageal cancer patients has increased over the past 30 years, which may be related to the improvement of surgical techniques, the improvement of systemic chemoradiation and the continuous acceptance of comprehensive treatment. Surgical treatment is still an integral part of the main treatment regimen for esophageal cancer. A variety of surgical options for esophageal cancer can be classified as transthoracic and diaphragmatic approaches. The main contradiction is that trans-thoracotomy is more extensive and more likely to be performed compared to transthoracic surgery with fewer complications and fewer deaths Achieve a better prognosis. A number of previous validations of these controversies have been made and concluded that neither of these two surgeries proved superior to the other and that patients achieved good short-term results with experienced surgeons. The literature also suggests that the experience of the surgeon and the management of esophageal cancer surgery in the hospital are important influencing factors for the complication and mortality of the operation. The former may exceed the impact of the choice of different surgical options. Trans-thoracic and diaphragmatic operation of the two surgical results similar.