[目的]观察比较三种术式治疗中下段食管癌的疗效及术后机体应激指标变化.[方法]80例中下段食管癌患者根据手术切口不同分为三组,A组25例行左胸单切口手术,B组28例行右胸+上腹部切口手术,C组27例行左颈部、右胸、腹正中切口手术,观察比较三组患者围手术期指标和淋巴结清扫数目,比较术前和术后患者血白细胞计数(WBC)、血清游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、C反应蛋白(CRP)、皮质醇变化,术后并发症及1年复发率.[结果]B组和C组患者手术时间、术后住院时间、术中出血量、留置引流管时间和淋巴结清扫数目均明显高于A组,且C组明显高于B组,差异均具有显著性(P<0.05).C组患者CRP和皮质醇显著高于A组和B组(P0.05).A组1年复发率明显高于B组和C组(P<0.05).[结论]三种食管癌切除术各有特点,需要综合考虑患者病情和自身条件来选择手术方式.“,”[Objective]To observe the effects of three surgical methods for treating middle and lower esophageal cancer and the changes of stress indexes.[Methods]Eighty patients with middle and lower esophageal cancer were divided into three groups.25 cases in group A were treated by left thoracic single-port resection,while 28 cases in group B were treated by right thoracic and abdominal resection,and 27 cases in group C were treated by left neck,right thoracic and median abdominal resection.The perioperative indexes and the number of dissected lymph nodes were compared between the groups,the white blood cell count (WBC),serum free triiodothyronine (FT3),free thyroxine (FT4),CRP,cortisol,postoperative complications and 1-year recurrence rate were also compared.[Results]The operation time,postoperative hospitalization time,intraoperative bleeding volume,drainage time and the number of dissected lymph nodes of the Group B and the Group C were significantly higher than those in the Group A,and the Group C was significantly higher than the B group,the difference was significant (P<0.05).CRP and cortisol of the Group C were significantly higher than those in the Group A and the Group B (P0.05).One year recurrence rate the Group A was significantly higher than that of the Group B and the Group C (P<0.05).[Conclusion]The three surgical methods have their own characteristics,and the appropriate surgery should be chosen according to the conditions of patients.