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目的探讨纵隔胸膜在中上段食管癌中应用的意义。方法选择肿瘤外科手术切除中上段食管癌482例,分为A、B两组。A组230例:2006年8月以前未缝合纵隔胸膜组;B组252例:2006年8月以后缝合组。两组患者肿瘤均位于食管中上段,其临床病理分期如下:Ⅰ期107例,Ⅱa期148例,Ⅱb期143例,Ⅲ期84例。结果所有患者均手术顺利,无近期死亡。吻合口瘘A组13例,B组4例;胸闷不适A组37例,B组13例。两组比较差异有统计学意义(P<0.05),改善了患者术后生存质量。严重的反流性食管炎、肺部感染、肺不张、切口感染等并发症在本研究组中差异无统计学意义(P>0.05)。结论在中上段食管癌,采用纵隔胸膜覆盖,明显减少吻合口瘘和胸闷不适的发生;而且操作简单,易于推广。
Objective To investigate the significance of mediastinal pleura in the middle and upper esophageal cancer. Methods Forty-eight cases of upper esophageal cancer resected by tumor surgery were divided into A and B groups. A group of 230 patients: no suture before August 2006 Mediastinal pleural group; 252 cases of group B: suture group after August 2006. The tumors of the two groups were located in the upper esophagus. The clinical stage was as follows: stage Ⅰ 107 cases, stage Ⅱ a 148 cases, stage Ⅱ b 143 cases and stage Ⅲ 84 cases. Results All the patients were operated smoothly without any recent deaths. Anastomotic fistula A group of 13 cases, B group 4 cases; chest discomfort in group A 37 cases, B group 13 cases. The difference between the two groups was statistically significant (P <0.05), improving the quality of life of patients after surgery. Serious reflux esophagitis, pulmonary infection, atelectasis, incision infection and other complications in this study there was no significant difference (P> 0.05). Conclusion In the upper and middle stage of esophageal cancer, the use of mediastinal pleura coverage significantly reduces the incidence of anastomotic fistula and chest tightness discomfort; and simple operation, easy to promote.