微创食管手术中食管悬吊法清扫左喉返神经旁淋巴结的临床疗效分析

摘要

Objective:To analyze effects of esophageal suspension on left recurrent laryngeal nerve lymph node dissection ,operation duration ,and perioperative morbidity in minimally invasive esophageal surgery .Methods:Clinical data of 145 patients with esophageal cancer treated by minimally invasive surgery in Zhongshan Hospital ,Fudan University ,from Jan . to Dec .2015 were retrospectively analyzed ,including 71 cases of esophageal suspension in left recurrent laryngeal nerve lymphadenectomy and other 74 cases of conventional methods .Results:Compared with the conventional method group ,left laryngeal recurrent nerve lymph node dissection number of the esophageal suspension group (2 .55 ± 0 .20 vs 1 .46 ± 0 .22 , P< 0 .05) increased significantly ,operation time ([262 .60 ± 6 .44] min vs [265 .60 ± 6 .17] min) and dissection time ([9 .90 ± 0 .34] min vs [9 .60 ± 0 .36] min) did not increase significantly ,and the related complications such as irreversible injury in recurrent laryngeal nerve and thoracic duct injury did not increase .Conclusions:Esophageal suspension in minimally invasive esophageal surgery helps improve the quality of left recurrent laryngeal nerve lymphadenectomy without increasing operation duration and perioperative morbidity .%目的：分析微创食管癌手术中食管悬吊法对左喉返神经旁淋巴结清扫情况、手术时间和相关并发症的影响。方法：回顾分析2015年1月－12月复旦大学附属中山医院微创手术治疗的145例食管癌患者的临床资料，其中71例术中用食管悬吊法清扫左喉返神经旁淋巴结，另74例术中用常规方法清扫左喉返神经旁淋巴结。结果：与常规方法组相比，食管悬吊组的左喉返神经旁淋巴结清扫数量显著增加[（2．55±0．20）枚 vs （1．46±0．22）枚，P＜0．05]，手术时间[（262．60±6．44） min vs （265．60±6．17） min]和左喉返神经旁淋巴结清扫时间[（9．90±0．34） min vs （9．60±0．36） min]无明显差异，喉返神经不可逆损伤、胸导管损伤等并发症无明显差异。结论：微创食管癌根治术中采用食管悬吊法可更彻底地清扫左喉返神经旁淋巴结，且不增加手术时间和围手术期并发症。