Guo Qiang, Li Hefei, Wang Haibo, Zhang Duo, Li Yonghui
Qiang Guo, Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China.
Hefei Li, Department of Thoracic Surgery, Affiliated Hospital of Hebei University, Baoding, Hebei 071000, P.R. China.
Pak J Med Sci. 2022 Mar-Apr;38(4Part-II):950-954. doi: 10.12669/pjms.38.4.4031.
To investigate the effects of standard two-field lymph node dissection (2FLND) and total 2FLND on the short-term and long-term clinical efficacy and complications of patients undergoing esophagectomy.
The clinical data of 268 patients undergoing radical Ivor-Lewis esophagectomy in our hospital from January 2008 to November 2015 were analyzed retrospectively. According to different methods of lymph node dissection (LND), the patients were divided into standard 2FLND group (n = 121) and total 2FLND group (n = 147). The LND status, postoperative complications, survival rate and lymph node recurrence of the two groups were analyzed.
Lymph node metastasis rate showed no statistically significant difference between the standard 2FLND group and the total 2FLND group (71.1% and 63.3%, respectively, > 0.05). The incidence of postoperative complications was 5.8% (7/121) in the standard 2FLND group, which was lower than that in the total 2FLND group [17.0% (25/147)], with a statistically significant difference ( = 7.948, < 0.01). The 5-year survival rate of the standard 2FLND group and the total 2FLND group was 29.8% and 28.6%, respectively, without statistically significant difference ( = 0.005, > 0.05). The lymph node recurrence rate in the standard 2FLND group was 41.3% (50/121), which was higher than 19.0% (28/147) of the total 2FLND group ( = 15.959, < 0.01).
Compared with standard 2FLND, total 2FLND does not improve the postoperative survival of patients with esophageal carcinoma, and the risk of complications is higher.
探讨标准两野淋巴结清扫术（2FLND）与全两野淋巴结清扫术对食管癌切除术患者短期和长期临床疗效及并发症的影响。
回顾性分析2008年1月至2015年11月在我院行根治性Ivor-Lewis食管癌切除术的268例患者的临床资料。根据不同的淋巴结清扫（LND）方法，将患者分为标准2FLND组（n = 121）和全2FLND组（n = 147）。分析两组的LND情况、术后并发症、生存率及淋巴结复发情况。
标准2FLND组与全2FLND组的淋巴结转移率差异无统计学意义（分别为71.1%和63.3%，>0.05）。标准2FLND组术后并发症发生率为5.8%（7/121），低于全2FLND组[17.0%（25/147）]，差异有统计学意义（=7.948，<0.01）。标准2FLND组和全2FLND组的5年生存率分别为29.8%和28.6%，差异无统计学意义（=0.005，>0.05）。标准2FLND组的淋巴结复发率为41.3%（50/121），高于全2FLND组的19.0%（28/147）（=15.959，<0.01）。
与标准2FLND相比，全2FLND不能提高食管癌患者术后生存率，且并发症风险更高。
