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目的研究评价早期和中期食管贲门癌切除手术伴迷走神经保留手术对根治性和预后生存的影响。方法选择在影像学上无明显外侵的早中期食管贲门癌136例,随机分为两组,比较保留组和对照组两组病例手术清扫淋巴结的数量;比较两组手术后淋巴结转移率和转移程度;比较两组的3,5年生存率。结果迷走神经保留组清扫淋巴结423个,对照组449个,两组差异无显著性(P>0.05)。手术后病理显示:迷走神经保留组淋巴结转移率为10.3%,转移度为2.8%;对照组分别为13.2%和4.5%,两组差异无显著性(P>0.05)。保留组术后3,5年生存率分别为75.5%和55.9%,对照组分别为72.1%和48.5%,两组差异亦无显著性(P>0.05)。结论早中期食管贲门癌切除伴迷走神经保留术,既能有效地保护术后消化功能,又不影响手术的根治性和手术后的生存时间。
Objective To evaluate the effect of early and mid-term esophageal and cardiac resections with vagal nerve preservation on radical and prognostic survival. Methods 136 cases of early and middle esophageal and cardiac cancer without obvious invasion were selected and randomly divided into two groups. The number of lymph node dissection between the two groups were compared. The lymph node metastasis rate and metastasis were compared between the two groups Degree; compare the two groups of 3, 5-year survival rate. Results There were 423 lymphatic nodes in the vagus nerve preservation group and 449 in the control group. There was no significant difference between the two groups (P> 0.05). The postoperative pathology showed that the rate of lymph node metastasis was 10.3% and the degree of metastasis was 2.8% in the group of vagotomy and the control group was 13.2% and 4.5% respectively. There was no significant difference between the two groups (P> 0.05). The 3-year and 5-year survival rates were 75.5% and 55.9% in the retention group and 72.1% and 48.5% in the control group, respectively, with no significant difference between the two groups (P> 0.05). Conclusions Early and mid-term resection of esophageal and cardial carcinoma with vagal nerve preservation can not only effectively protect postoperative digestive function, but also not affect the radical operation and survival time after surgery.