食管癌三野淋巴结清扫根治术65例临床分析_West China Medical Journal

Authors：

 蔡彦力 ,  姚元波 , 黄进启 , 郑勇 , 向水 , 李林浩

恩施土家族苗族自治州中心医院心胸外科（湖北恩施 445000）;

Corresponding author：

姚元波, Email: caiyl_2004@sina.com

Keywords：

食管癌; 外科治疗; 三野淋巴结清扫术

DOI：

10.7507/1002-0179.201600429

Video：

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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。

Citation： 蔡彦力, 姚元波, 黄进启, 郑勇, 向水, 李林浩. 食管癌三野淋巴结清扫根治术65例临床分析. West China Medical Journal, 2016, 31(9): 1575-1577. doi: 10.7507/1002-0179.201600429 Copy

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1. 赫捷. 食管癌规范化诊疗指南[M]. 2版. 北京:中国协和医科大学出版社, 2011:39.
2. Sugiyama M, Morita M, Yoshida R, et al. Patterns and time of recurrence after complete resection of esophageal cancer[J]. Surg Today, 2012, 42(8):752-758.
3. 张志庸. 协和胸外科学[M]. 2版. 北京:科学出版社, 2010:683-685.
4. Liu Q, Cai XW, Wu B, et al. Patterns of failure after radical surgery among patients with thoracic esophageal squamous cell carcinoma:implications for the clinical target volume design of postoperative radiotherapy[J]. PLoS One, 2014, 9(5):e97225.
5. 缪珑异, 相加庆. 食管癌三野淋巴结清扫根治术的价值[J]. 中国癌症杂志, 2004, 14(2):194-196.
6. Matsubara T, Ueda M, Abe T, et al. Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic oesophagus[J]. Br J Surg, 1999, 86(5):669-673.
7. Berger AC, Bloomenthal A, Weksler B, et al. Oncologic efficacy is not compromised, and may be improved with minimally invasive esophagectomy[J]. J Am Coil Surg, 2011, 212(4):560-568.
8. 佘志廉. 食管癌颈胸腹淋巴结清扫研究[J]. 中国肿瘤, 2001, 10(3):148-149.
9. Ding X, Zhang J, Li B, et al. A meta-analysis of lymph node metastasis in thoracic esophageal cancer[J]. Br J Radiol, 2012, 85(1019):e1110-e1119.
10. Udagawa H, Ueno M, Shinohara H, et al. The importance of grouping of lymph node stations and rationale of three-field lymphoadenectomy for thoracic esophageal cancer[J]. J Surg Oncol, 2012, 106(6):742-747.
11. Ye T, Sun Y, Zhang Y, et al. Three-field or wo-field resection for thoracic esophageal cancer:a meta-analysis[J]. Ann Thorac Surg, 2013, 96(6):1933-1941.

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食管癌三野淋巴结清扫根治术65例临床分析

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