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目的探讨三野淋巴结清扫根治术治疗胸段食管癌的必要性及手术体会。方法回顾性分析2014年1月-10月65例行三野淋巴结清扫根治术胸段食管癌患者的临床病理资料。结果 65例患者均获根治性切除,术后死亡1例,喉返神经麻痹25例,肺部感染12例,心律失常5例,颈部乳糜瘘1例,颈部吻合口瘘1例。平均每例清扫淋巴结(44.8±5.4)枚,淋巴结转移率为61.5%(40/65),淋巴结转移度为11.37%(331/2 912)。各胸段食管癌均可发生下颈部、全纵隔及上腹部淋巴结转移。结论食管癌三野淋巴结清扫术有助于提高手术根治性和病理分期的准确性,从而提高术后远期疗效,是一种有效可行的术式。
Objective To investigate the necessity and surgical experience of three-node lymphadenectomy in the treatment of thoracic esophageal cancer. Methods The clinical and pathological data of 65 patients with thoracic esophageal cancer who underwent radical three-node lymphadenectomy from January 2014 to October 2014 were analyzed retrospectively. Results All 65 patients underwent radical resection. There were 1 postoperative death, 25 paralytic recurrent laryngeal nerve, 12 pulmonary infection, 5 arrhythmia, 1 cervical neck fistula and 1 cervical anastomotic fistula. The average number of dissected lymph nodes was 44.8 ± 5.4, the rate of lymph node metastasis was 61.5% (40/65), and the degree of lymph node metastasis was 11.37% (331/2 912). Thoracic esophageal cancer can occur under the neck, the mediastinum and upper abdominal lymph node metastasis. Conclusions Esophageal cancer three-node lymphadenectomy can help to improve the accuracy of the radical and pathological staging of the esophageal cancer so as to improve the long-term postoperative efficacy. It is an effective and feasible surgical procedure.