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目的探讨经右胸-腹部双切口在治疗食管中、上段癌中的应用。方法比较经右胸-腹部双切口(A组,82例)、经左胸-颈部双切口(B组,65例)、经右胸-腹部颈部三切口(C组,106例)治疗食管中、上段癌的效果。结果三组肿瘤切除率、切缘阳性率、手术死亡率、5年生存率无明显差别。三组清扫淋巴结数目分别为A组(10.3±4.1)个,B组(9.8±4.5)个,C组(13.8±5.5)个,C组明显多于A、B两组(P<0.01);A组手术并发症发生率37.8%,明显低于C组的44.8%(P<0.01);A组吻合口瘘发生率明显低于B、C组(2.4%vs.10.8%、10.3%)(P<0.01)。结论经右胸-腹部双切口适用于治疗食管中、上段癌。
Objective To explore the application of right thoracic-abdominal incision in the treatment of upper esophageal cancer. Methods The right thoracic-abdominal double incision (group A, n = 82) was treated by left thoracic-cervical double incision (group B, 65 cases) through the right thoracic-abdominal neck incision (group C, 106 cases) Esophagus, upper cancer effect. Results Three groups of tumor resection rate, positive margins, surgical mortality, 5-year survival rate no significant difference. The number of lymph nodes in the three groups were 10.3 ± 4.1 in group A, 9.8 ± 4.5 in group B and 13.8 ± 5.5 in group C, respectively. The number of lymph nodes in group C was significantly higher than that in group A and B (P <0.01). The incidence of surgical complications in group A was 37.8%, which was significantly lower than that in group C (44.8%, P <0.01). The incidence of anastomotic fistula in group A was significantly lower than that in group B and C (2.4% vs.10.8%, 10.3% P <0.01). Conclusion The right thoracic-abdominal incision is suitable for the treatment of middle and upper esophageal cancer.