关键词: 食管鳞癌, 改良喉返神经旁淋巴结清扫, 预后

Abstract: Objective To compare the surgical parameters,complications and prognosis of patients with esophageal squamous cell carcinoma treated by thoracoscopic modified recurrent laryngeal nerve lymph node dissection and traditional lymph node dissection. Methods The data of 162 patients who underwent thoracoscopic esophageal carcinoma resection in our hospital from March 2015 to August 2019 were retrospectively analyzed.Among them,73 patients underwent traditional lymph node dissection and 89 patients underwent modified recurrent laryngeal nerve lymph node dissection.Operation-related indicators(duration of operation,intraoperative blood loss,duration of postoperative drainage tube indwells and length of stay),lymph node dissection,postoperative complications and Disease free survival(DFS) were compared between the two groups.Finally,independent prognostic factors affecting DFS were screened by COX univariate and multivariate analysis. Results In the modified group, the operative time was (125.65±23.85) min, the intraoperative blood loss was (215.69±26.37)ml, the postoperative drainage tube indwelling time was (7.04±1.31) days, and the hospital stay was (11.51±2.43) days,while in the traditional group they were (123.76±25.05) minutes, (211.29±20.21)ml, (7.11± 1.62 )days, (11.72±2.71)days,respectively.no statistically significant difference were observed in the two groups (all  P ＞0.05).The time of RLNLN dissection in the modified group was less than that in the traditional group,and the number of left and right RLNLN dissection was more than that in the traditional group,the incidence of recurrent laryngeal nerve injury in the modified group(2.2%) was significantly lower than that in the traditional group(11.0%)(all  P <0.05).COX multivariate analysis showed that modified recurrent laryngeal nerve lymph node dissection,tumor stage and tumor differentiation were independent prognostic factors for DFS( P =0.022,0.037,0.026). Conclusion Improved recurrent laryngeal nerve lymph node dissection has certain advantages over traditional lymph node dissection,and is associated with better prognosis of patients.

Key words: esophageal squamous cell carcinoma, improved recurrent laryngeal nerve lymph node dissection, prognosis