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目的：比较高龄食管下段癌患者采用二切口和三切口两种不同手术路径手术治疗的临床效果。方法：回顾性分析高龄食管下段癌患者135 例，其中73 例患者采用二切口术式，分为A 组；62 例患者采用三切口术式，分为B 组，比较两组患者术中出血量、手术时间、食管切除长度、淋巴结清扫数目及术后并发症、术后死亡率和1 年后生存率、生活质量。结果：A 组术中出血量、手术时间优于B 组；B 组食管切除长度、淋巴结清扫数目优于A 组；A 组术后并发症及死亡率低于B 组、术后生活质量优于B 组；术后1 年生存率两组无显著性差异。结论：高龄食管下段癌患者手术治疗时，应首选二切口术式，可减少术后并发症的发生，并提高术后生活质量。

英文摘要:

Objective: To compare the clinical effects of two incisions and three incisions surgical approaches in treatment of elderly patients with lower esophageal cancer. Methods: Retrospective analysising 135 cases of elderly patients with lower esophageal cancer, 73 patients were divided into A group with two incisions surgical approaches treatment. 62 patients were divided into B group with three incisions surgical approaches treatment,then compare surgery bleeding,operation time, the length of esophageal resection, the number of lymph node,surgery complications,mortality rate, postoperative one year survival rate and quality of life. Results: A group was better than B group in surgery bleeding, operation time, surgery complications and quality of life, B group was better than A group in the length of esophageal resection and the number of lymph node, there was no significant difference in survival after 1 year (P＞0.05). Conclusion: In surgical treatment of elderly patients with lower esophageal cancer,it should use two incisions surgical approaches first.It could reduce surgery complications and improve quality of life.

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