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目的探讨体重指数(BMI)对食管癌根治术的根治效果及手术风险的影响。方法回顾性分析2014年3月至2015年3月四川大学华西医院胸外科行食管癌根治术494例患者的临床资料,其中男296例、女98例,年龄60(36~81)岁。根据BMI将患者分为三组:肥胖组(BMI≥25 kg/m~2),74例;正常体重组(18.5 kg/m~2≤BMI<25 kg/m~2),345例;低体重组(BMI<18.5 kg/m~2),75例。结果低体重组、正常体重组和正常体重组术中出血量[(213.33±55.10)ml vs.(218.90±60.76)ml vs.(217.30±61.10)ml]、手术时间[(197.07±52.47)min vs.(208.35±96.84)min vs.(182.84±63.06)min]、术后总并发症发生率[38.7%(29/75)vs.43.2%(149/345)vs.39.2%(29/74)]、淋巴结清扫数(916.18±6.64 vs.16.68±8.48 vs.17.07±8.26)和转移淋巴结清扫数目(1.42±2.53 vs.1.32±2.51 vs.2.45±4.08)的差异均无统计学意义。结论肥胖和低体重不会增加食管癌患者手术风险或影响手术根治效果,故肥胖和低体重不应影响食管癌患者对手术治疗的选择。
Objective To investigate the effect of body mass index (BMI) on the curative effect and surgical risk of esophageal cancer radical operation. Methods The clinical data of 494 patients undergoing esophageal cancer radical mastectomy from March 2014 to March 2015 in West China Hospital of Sichuan University were retrospectively analyzed. There were 296 males and 98 females, aged 60 to 36 years old. According to BMI, the patients were divided into three groups: obesity group (BMI≥25 kg / m ~ 2), 74 cases, normal weight group (18.5 kg / m ~ 2≤BMI <25 kg / Body weight (BMI <18.5 kg / m ~ 2), 75 cases. Results The amount of bleeding in the low body weight group, normal body weight group and normal body weight group [(213.33 ± 55.10) ml vs. (218.90 ± 60.76) ml vs. (217.30 ± 61.10) ml] and operation time (197.07 ± 52.47) min (208.35 ± 96.84) min vs. (182.84 ± 63.06) min]. The overall postoperative complication rate was 38.7% (29/75) vs.43.2% (149/345) vs.39.2% (29/74) ), The number of lymph node dissection (916.18 ± 6.64 vs.16.68 ± 8.48 vs.17.07 ± 8.26) and the number of lymph node dissection (1.42 ± 2.53 vs.1.32 ± 2.51 vs.2.45 ± 4.08) had no statistical significance. Conclusion Obesity and low body weight will not increase the risk of surgical treatment of esophageal cancer patients or affect the curative effect of surgery. Therefore, obesity and low body weight should not affect the choice of surgical treatment for esophageal cancer patients.