20 / 10 / 16
关于“复合微创食管切除术治疗食管癌”一文医学翻译摘要学习情况，记录于此。
Hybrid Minimally Invasive Esophagectomy for Esophageal Cancer
摘要
Abstract
背景
BACKGROUND
因食管癌接受开放食管切除术的患者有一半以上会出现术后并发症，尤其是肺部并发症。目前尚不明确复合微创食管切除术与开放食管切除术相比可否降低并发症发病率。
Postoperative complications, especially pulmonary complications, affect more than half the patients who undergo open esophagectomy for esophageal cancer. Whether hybrid minimally invasive esophagectomy results in lower morbidity than open esophagectomy is unclear.
笔记：
方法
METHODS
我们开展了一项多中心、开放标签的随机对照试验，纳入患可切除的食管中段癌或下段癌，年龄18～75岁的患者。患者被随机分组，分别接受经胸开放食管切除术（开放手术）或复合微创食管切除术（复合手术）。通过鉴定外科医师资质、标准化操作和监测表现三种方式保证外科手术质量。复合手术包括胸腹二野手术（也称为Ivor-Lewis手术），即腹腔镜胃游离术和右侧开胸术。主要终点是术中或术后30日内根据Clavien-Dindo分级系统判定的Ⅱ级或更高级别并发症（表示需要干预的主要并发症）。根据意向治疗原则进行分析。
We performed a multicenter, open-label, randomized, controlled trial involving patients 18 to 75 years of age with resectable cancer of the middle or lower third of the esophagus. Patients were randomly assigned to undergo transthoracic open esophagectomy (open procedure) or hybrid minimally invasive esophagectomy (hybrid procedure). Surgical quality assurance was implemented by the credentialing of surgeons, standardization of technique, and monitoring of performance. Hybrid surgery comprised a two-field abdominal–thoracic operation (also called an Ivor–Lewis procedure) with laparoscopic gastric mobilization and open right thoracotomy. The primary end point was intraoperative or postoperative complication of grade II or higher according to the Clavien–Dindo classification (indicating major complication leading to intervention) within 30 days. Analyses were done according to the intention-to-treat principle.
笔记：
第一、二句是论文经典句型
个人倾向第三句处理为“外科手术质量通过ABC保证”
第三句中with在中文的处理值得学习
最后一句的analyses were done有点意思
结果
RESULTS
从2009年10月至2012年4月，我们将103例患者随机分配到复合手术组，将104例患者随机分配到开放手术组。根据记录，110例患者共发生312起严重不良事件。复合手术组共有37例患者（36%）发生术中或术后主要并发症，而开放手术组为67例（64%）（比值比，0.31；95%置信区间[CI]，0.18～0.55；P＜0.001）。复合手术组102例患者中共有18例（18%）发生肺部主要并发症，而开放手术组103例患者中有31例（30%）。3年时，复合手术组的总生存率为67%（95% CI，57%～75%），而开放手术组为55%（95% CI，45%～64%）；无病生存率分别为57%（95% CI，47%～66%）和48%（95% CI，38%～57%）。
From October 2009 through April 2012, we randomly assigned 103 patients to the hybrid-procedure group and 104 to the open-procedure group. A total of 312 serious adverse events were recorded in 110 patients. A total of 37 patients (36%) in the hybrid-procedure group had a major intraoperative or postoperative complication, as compared with 67 (64%) in the open-procedure group (odds ratio, 0.31; 95% confidence interval [CI], 0.18 to 0.55; P<0.001). A total of 18 of 102 patients (18%) in the hybrid-procedure group had a major pulmonary complication, as compared with 31 of 103 (30%) in the open-procedure group. At 3 years, overall survival was 67% (95% CI, 57 to 75) in the hybrid-procedure group, as compared with 55% (95% CI, 45 to 64) in the open-procedure group; disease-free survival was 57% (95% CI, 47 to 66) and 48% (95% CI, 38 to 57), respectively.
笔记：
结论
CONCLUSIONS
我们发现，与开放食管切除术相比，复合微创食管切除术降低了术中和术后主要并发症，尤其是肺部并发症的发生率，同时未影响3年期间的总生存率和无病生存率（由法国国家癌症研究所[National Cancer Institute]资助；在ClinicalTrials.gov注册号为NCT00937456）。
We found that hybrid minimally invasive esophagectomy resulted in a lower incidence of intraoperative and postoperative major complications, specifically pulmonary complications, than open esophagectomy, without compromising overall and disease-free survival over a period of 3 years. (Funded by the French National Cancer Institute; ClinicalTrials.gov number, NCT00937456 .)
笔记：