ESOPHAGECTOMY BY A TRANSHIATAL APPROACH OR THORACOTOMY - A PROSPECTIVE RANDOMIZED TRIAL
ESOPHAGECTOMY BY A TRANSHIATAL APPROACH OR THORACOTOMY - A PROSPECTIVE RANDOMIZED TRIAL
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DOI：
10.1002/bjs.1800800335
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发表时间：
1993-03-01
影响因子：
9.6
通讯作者：
LAUNOIS, B
中科院分区：
文献类型：
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作者：
GOLDMINC, M;MADDERN, G;LAUNOIS, B
在40个月的时间内，对67例接受经裂孔入路或右侧开胸食管切除术的患者进行了前瞻性随机试验。32例患者的入路为经裂孔入路，35例患者的入路为开胸入路;两组患者术前匹配良好。有两个医院死亡的患者有transshiatal食管切除术和三个开胸手术。输血、重症监护时间和总住院时间在两组之间没有显著差异。术后发病率没有差异，特别是肺部并发症的发生率相似（经裂孔食管切除术为19%，开胸术为20%），吻合口瘘分别为6%和9%。开胸术患者的中位（范围）手术时间显著更长（6（3.5-9.5）vs 4（3-8）h）。长期生存率不受手术类型或术前化疗或放疗的影响。淋巴结状态是两组内但不是两组之间的重要预后因素。结论：经裂孔食管切除术或右胸切开术是治疗食管鳞状细胞癌同样有效的手术选择。
A prospective randomized trial of 67 patients undergoing oesophagectomy by either a transhiatal approach or right-sided thoracotomy was conducted over a 40-month period. In 32 patients the approach was transhiatal and 35 had a thoracotomy; the groups were well matched before operation. There were two hospital deaths in patients having the transhiatal oesophagectomy and three in those undergoing thoracotomy. Blood transfusion, intensive care stay and overall time of hospitalization were not significantly different between the two groups. There was no difference in the postoperative morbidity rate and, in particular, the incidences of pulmonary complications were similar (19 per cent for transhiatal oesophagectomy, 20 per cent for thoracotomy) with anastomotic fistula in 6 and 9 per cent respectively. The median (range) operating time was significantly longer in patients having thoracotomy (6 (3.5-9.5) versus 4 (3-8) h). Long-term survival was unaffected by the type of operation performed or addition of preoperative chemotherapy or radiotherapy. Nodal status was a significant prognostic factor within but not between the two groups. It is concluded that oesophagectomy by a transhiatal route or right thoracotomy are equally effective surgical options for treatment of squamous cell oesophageal cancer.