Objective: To compare the therapeutic effect of two kinds of transthoracic operative approaches for patients with middle thoracic esophageal cancer. Method: Survival analysis was used to investigate operation complications, lymph node dissection and survival rate of 34 patients undergoing left thoracic approach ( left approach group ) and 42 patients undergoing right thoracic approach ( right approach group ) from January 2002 to December 2007. Result: The number of lymph nodes resected in right approach group was more than in left approach group( 16. 9±6. 4 vs 12. 1±5. 3 , P<0. 05 ); 3 years recurrence rate in left approach group was higher than that in right approach group ( P< 0. 05 ), while the 3 years overall survival rate in left approach group was lower than that in the right approach group ( P <0. 05 ); operation time and blood loss in left approach were 225. 5 ± 38. 9 and 459. 4 min ±50. 2 mL, which were better than those in right approach group ( P<0. 05 ). Conclusion: Right transthoracic resection increases the incidence of complications , but it can reduce lymphatic recurrence rate and increase disease-free survival rate.%目的:比较左胸和右胸入路治疗胸中段食管癌的疗效差异.方法:选取我院自2002年1月至2007年12月收治的34例行左胸入路治疗(左胸组)和42例行右胸入路治疗(右胸组)患者,回顾性分析两种径路的手术并发症、淋巴结清扫情况及生存率.结果:左胸组清扫淋巴结12.1±5.3枚,右胸组清扫淋巴结16.9±6.4枚(P＜0.05);左胸组3年复发率高于右胸组(P<0.05),3年总生存率低于右胸组(P<0.05);左胸组并发症总发生率为23.53%,低于右胸组的47.62% (P<0.05);左胸组手术时间和术中出血量分别为225.5±38.9 min和459.4±50.2mL,优于右胸组的288.3±49.8min和519.1±69.2 mL(P<0.05).结论:经右胸入路操作复杂,并发症较多,但可减少淋巴结复发,并提高无病生存率.
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