腔镜微创食管癌根治术治疗Siewert I型胃食管结合部鳞癌的短期疗效评估

目的：探讨腔镜微创食管癌根治术治疗Siewert I型胃食管结合部鳞癌患者的短期临床疗效及安全性。方法：选取我科2009年1 月1 日至2012 年3 月1 日收治的Seiwert I型胃食管结合部鳞癌患者114 例，并将其随机分为开胸食管切除术组(59 例)和腔镜微创食管切除术组(55 例)，评估并比较两组的短期临床疗效及并发症的发生情况。结果：微创食管切除术组患者术后生存质量评分评分均显著高于开胸食管切除术组(P<0.05)，患者2 年生存率为83.6%(46/55)，高于开胸食管切除术组(47/59，79.7%)。此外，微创食管切除术组肺部并发症(9.09%vs 28.81%)和声带麻痹(0%vs 15.25%)的发生率均显著低于开胸食管切除术组(P<0.05)。结论：腔镜微创食管癌根治术可显著提高Siewert I型胃食管结合部鳞癌短期疗效。

The Short-TermEfficacy of Three-Field Minimally Invasive Esophagectomyin the treatment of Siewert Type I Esophago-gastric Junctional SquamousCarcinoma

Objective:To evaluate the short-term efficacy and safety of three-field minimally invasive esophagectomy in thetreatment of Siewert type I esophago-gastric junctional squamous carcinoma.Methods:From January 1, 2009, to March 1, 2012, 114consecutive patients with Siewert type I esophagogastric junctional suamous carcinoma were involved in this retrospective study. Patientswere randomly assigned by acomputer-generated randomization sequence to receive either three-incision open esophagectomy orminimally invasive esophagectomy. Details concerning short-term efficacy and complications were collected and analyzed.Results:Totally, 59 patients were involved in the open esophagectomy group and 55 patients were involved in the minimally invasiveesophagectomy group. The incidence of pulmonary morbidity (9.09%versus 28.81%) and vocal cord paralysis (0%versus 15.25%) in theminimally invasive group were significantly lower than those in the open esophagectomy group (P<0.05). Furthermore, the postoperativequality of life in the minimally invasive esophagectomy group was better than that in the open esophagectomy group. The 2-year survivalrate was 83.6%in the minimally invasive esophagectomy group (46 of 55 patients) and 79.7%in the open esophagectomy group (47 of59patients), no significant difference was observed (P>0.05).Conclusion:Minimally invasive esophagectomy could significantly improvethe short-termefficacy of patients with Siewert type I esophagogastric junctional suamous carcinoma.