目的 探讨并分析胸腹腔镜下胸中上段食管癌三野淋巴结清扫术的安全性及短期疗效.方法 回顾性分析2013年12月至2015年12月收治的98例胸中上段食管癌患者的临床资料及近期随访结果, 所有患者均行胸腹腔镜手术, 其中50例行三野淋巴结清扫术 (三野组) , 48例行二野淋巴结清扫术 (二野组) , 比较两组患者围术期相关指标、淋巴结清扫数、淋巴结转移率、术后并发症、颈部淋巴结复发率和生存率.结果 胸腹腔镜三野组淋巴结清扫手术时间较二野组长, 差异有统计学意义 (P0.05) .三野组与二野组平均清扫淋巴结数分别为 (22.94±3.26) 枚、 (15.41±1.84) 枚, 淋巴结转移率分别为66.00％ (33/50) 、43.75％ (21/48) , 差异均有统计学意义 (P0.05) .三野组术后1年、2年颈部淋巴结复发率较二野组低, 差异有统计学意义 (P0.05) .The average number of lymph node dissection in the three-field and two-field groups were 22.94±3.26 and 15.41±1.84 respectively, the lymph node metastasis rates were 66.00％ (33/50) and 43.75％ (21/48) respectively, the differences were statistically significant (P0.05) .The postoperative 1-year and 2-year recurrence rate of cervical lymph nodes in the three-field group were lower than those in the two-field group (P<0.05) .The postoperative 1-year and2-year survival rates in the three-field group were significantly higher than those in the two-field group (P<0.05) .Conclusion Thoracolaparoscopy three-field lymphadenectomy in the treatment of upper and middle thoracic esophageal carcinoma is safe and feasible, and the lymph node dissection is more thorough, which can reduce the local recurrence rate, increases the postoperative survival rate, and has a certain clinical application value.
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