食管癌切除主动脉弓上与弓下吻合术的疗效分析

摘要

Objective To compare the efficacies of inosculation above the aortic arch and under the aortic arch through left chestrnnotches esophagectomy for treating esophageal cancer．Methods 3 1 4 patients with thoracic esophageal cancer performed left chestrnnotches esophagetomy with anastomosis above or under the aortic arch were retrospectively analyzed and divided into the above aorrntic arch group and under aortic arch group according to the operation modes．The clinical data were statistically analyzed．ResultsrnThe residual cancer rate of upper incisal edge in the under aortic arch group was higher than that in the above aortic arch group(P0．05)．Conclusion The degree of lymphatic nodes metastasis and the oprneration mode are the important factors influencing prognosis of esophageal cancer．In the patients with thoracic esophageal cancerrnwithout obvious infiltration or extensive lymph nodes metastasis。Inosculation above the aortic arch through left chest notchesrnesophagectomy should be selected for increasing the long term survival rate．%目的 比较经左胸食管癌切除主动脉弓上吻合术与弓下吻合术的疗效.方法 回顾性分析经左胸食管-胃主动脉弓上吻合术及弓下吻合术的314例胸段食管癌病例,根据手术方式分为弓上组与弓下组.比较两组患者的手术情况、术后并发症及5年生存率.结果 上切缘癌残留率弓下组明显高于弓上组(8.5%与3.8%,P<0.05),手术时间弓上组明显长于弓下组、淋巴结清扫数弓上组明显多于弓下组(P<0.05);而两组患者术后院内死亡率、吻合口瘘发生率及5年生存率比较,差异无统计学意义(P>0.05).结论 淋巴结转移程度和手术方式是影响食管癌预后的重要因素.对于肿瘤没有明显外侵或无广泛淋巴结转移的胸段食管癌患者,宜选择主动脉弓上吻合,以期提高患者的长期生存率.