胸腔镜辅助食管癌根治并胸内吻合术临床分析  

Video-assisted thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophagealanastomosis in thoracic cavity： analysis of 60 cases

作　　者：孙翔翔[1] 徐美青[1] 郭明发[1] 柳常青[1] 徐世斌[1] 梅新宇[1] 田介勇[1] 张正华[1] 魏大中[1] 

机构地区：[1]安徽医科大学附属安徽省立医院胸外科,合肥230001

出　　处：《中华外科杂志》2013年第4期354-357,共4页Chinese Journal of Surgery

摘　　要：目的评价胸腔镜辅助经右胸食管癌根治并行胸内吻合术的可行性和安全性。方法回顾性分析2011年3月至12月拟行胸腔镜辅助经右胸食管癌根治并行胸内吻合术（腔镜组）60例患者的临床资料，其中男性41例，女性19例；年龄47—80岁，平均（62±7）岁。并分析同期施行传统右胸、上腹两切口食管癌根治术（开放组）60例患者的临床资料，其中男性39例，女性21例；年龄46～73岁，平均（62±9）岁。比较两组手术相关指标和术后并发症情况。结果两组均顺利完成手术。围手术期无死亡病例。两组术中出血量、术后3d总引流量和住院总费用差异无统计学意义。腔镜组胸腔内操作时间长于开放组[（188±38）rain比（138±50）min，t=6．171，P=0．000]。腔镜组术后住院时间短于开放组[（14±3）d比（18＋6）d，t=-4．093，P=0．000]，淋巴结数少于开放组[（17±9）枚比（214-11）枚，t=-2．058，P=0．042]，主要并发症发生率低于开放组（25．0％比48．3％，X^2=7．033，P=0．008）。结论胸腔镜辅助经右胸食管癌根治并行胸内吻合术治疗中下段食管癌是可行和安全的，手术创伤小、恢复快，近期效果满意。Objective To investigate the feasibility and safety of video-assisted thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity. Methods The clinical data of 120 patients who underwent esophagectomy for esophageal carcinoma and gastro- esophageal anastomosis in right thoracic cavity from March to December 2011 was analyzed retrospectively. In the video-assisted thoracoscopic surgery group, there were 60 patients [ 41 male and 19 female patients with aver age of （62± 7 ） years old ] who underwent video-assisted thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity. In the routine thoracotomy group, there were 60 patients [ 39 male and 21 female patients with aver age of （62± 9 ） years old ] who underwent routine thoracotomy esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity. Operation time, intra-operative blood loss, postoperative total thoracic drainage in 3 days, total number of harvested lymph nodes, hospitalization, cost of hospitalization and complications were compared between the two groups. Result The operations were carried out successfully in two groups. There was no perioperative death in all patients. There was no statistical difference in intra-operative blood loss, postoperative total thoracic drainage and cost of hospitalization between the two groups. Operation time of rideo-assisted thoracoscopic surgery group was significantly longer than that of thoracotomy group （ （ 188 ± 38） minutes vs. （138 ± 50） minutes, t = 6. 171, P = 0.000）, but postoperative hospitalization was significantly lower （ （ 14 ± 3 ） d vs. （ 18 ± 6） d, t = - 4. 093, P = 0. 000） and total number of harvested lymph nodes was lower （ 17±9 vs. 21 ± 11, t = - 2. 058, P = 0. 042）. There was significantly statistical difference in total postoperative main complication （25.0% vs. 48.3%, vs = 7. 033, P = 0. 008 ）. And postoperative

关 键 词：食管肿瘤 胸腔镜检查 食管切除术 吻合术 外科 

分 类 号：R735.1[医药卫生—肿瘤]