The Evaluation Of Short-term Outcome In Selective Three-field And Two-field Lymphadenectomy In The Treatment Of Thoracic Esophageal Squamous Cell Carcinoma

Objective Currently,the overall therapeutic effect of esophageal squamous carcinoma is not satisfied,The current treatment for esophageal cancer is the main multidisciplinary surgical treatment of esophageal carcinoma after radical surgery is the most effective measures to control the recurrence and metastasis of esophageal cancer,but the surgery can cause many complications.Esophageal squamous cell carcinoma radical surgery according to the extent of lymph node dissection can be divided into three-field lymph node dissection and two-field lymph node dissection.this study according to the location of the lesion and preoperative imaging to determine elective cervical lymph node metastasis was decided to make three-field lymph node dissection.Comparative analysis of lymph node dissection for esophageal cancer and recent clinical efficacy by three-field lymph node dissection and two field lymph node dissection.Methods Retrospectively analyzed the clinical characteristics of 85 patients with esophagcetomy in May 2013 to October 2015 in the jiangdu people’s hospital of yangzhou city.selective three-field lymph node dissection in 35 cases(3-FLD),two-field lymph node dissection in 50 cases(2-FLD,right chest and abdomen surgery).Compare of two groups patients with perioperative complication rates and the number of lymph node cleaning and lymph node metastasis rate and other indicators.Results In the group perioperative death was not observed,Intraoperative index:The 3-FLD group operation time(236.29± 16.69)min,The 2-FLD group operation time(201.80±16.06)The 3-FLD group operative blood lost(126.00±22.12)ml,The 2-FLD group operative blood lost(112.20±39.19)ml.Postoperative index:The 3-FLD group cleaned the lymph nodes(30.91 ±8.49),The 2-FLD group cleaned lymph nodes(22.28±3.59).The 3-FLD group postoperative lymph node positive rate was 9.1%(99/1082),The 2-FLD group lymph node positive rate was 2.2%(25/1114)after surgery.The 3-FLDgroup pulled the chest tube(5.31±2.75)day,The 2-FLD group pulled the chest tube(5.02±3.67)day.The 3-FLD group stay in hospital after operation was(16.49±3.91)day,The 2-FLD group stay in hospital after operation was(14.66±4.27)day.Postoperative complications:The 3-FLD group gastric emptying disorder rate was 5.7%(2/35),The 2-FLD group gastric emptying disorder rate was 2.0%(1/50).The incidence was 11.4%(4/35)in 3-FLD group of anastomotic leakage after operation,the incidence was 2.0%(1/50)in The 2-FLD group of anastomotic leakage after operation.The 3-FLD group of pulmonary infection rate was 11.4%(4/35),The 2-FLD group of lung infection rate was 4.0%(2/50).The 3-FLD group incidence of arrhythmia was 17.1%(6/35),The 2-FLD group incidence of arrhythmia was 4.0%(2/50).The 3-FLD group laryngeal recurrent nerve injury incidence of 11.4%(4/35),The 2-FLD group laryngeal recurrent nerve injury incidence rate was 0%(0/50).The 85 patients were followed up.following-up deadline was to April 2016.The 3-FLD group followed-up time:19 months.The 2-FLD group followed-up time:23 months,and 1 case was lost to follow-up,2 cases died,And the other 82 cases of living.Conclusion Three-field lymphadenectomy was safe and feasible in technology for middle and upp thoracic esophageal cancer,surgical complications was almost in the two methods,three-field lympha.denectomy was able to completely removed lymph nodes,more lymph nodes were provided to achieve accurate postoperative staging the short-term efficacy of reliable,potentially screening for the benefit of the population,long term oncologic evaluation needs to be further follow up and discuss.