胸腹腔镜联合食管癌根治术与传统食管癌根治术同期临床对照研究  

Radical resection of esophagus carcinoma by open versus minimally invasive approaches: a clinical study of 108 cases

作　　者：蔡华荣[1] 羽平[1] 周洪[1] 江跃全[1] 

机构地区：[1]重庆市肿瘤研究所胸外科,重庆400030

出　　处：《第三军医大学学报》2014年第20期2142-2144,共3页Journal of Third Military Medical University

摘　　要：目的探讨胸腹腔镜联合下食管癌根治术治疗食管癌的临床疗效。方法回顾性分析2012年10月至2014年6月在本科因食管癌行食管癌根治术患者108例。51例患者行胸腹腔镜食管癌根治术(minimally invasive esophagectomy,MIE),57例患者行传统开放食管癌根治术(open esophagectomy,OE)。从手术结局、肿瘤学结局、围术期并发症三方面评估两种手术的临床疗效。结果两组患者一般资料比较无显著性差异(P>0.05)。MIE组与OE组手术时间,术中输血患者比例无明显差异(P>0.05)。MIE组和OE组比较,术中出血量[(150.5±30.4)vs(215.5±40.4)mL],术中平均输液量(2.2 vs 3.1 L),术后ICU监护时间(1 vs 2 d),禁食时间(6 vs 8 d),术后住院时间(8 vs 10 d)有显著性差异(P<0.05)。两组患者平均淋巴结切除数目、切缘阳性率无显著性差异(P>0.05),肺部并发症发生率MIE组2例(3.9%),明显少于OE组25(43.8%)。结论胸腹腔镜联合下食管癌根治术不仅可以达到与开放手术相同的肿瘤切除效果,且在减少术后住院时间、术中出血量及减少术后肺部并发症方面较开放手术更有优势。Objective To compare the clinical efficacy of minimally invasive esophagectomy（ MIE）versus open esophagectomy（ OE） in radical resection of esophagus carcinoma.Methods Clinical data of 108 patients with esophageal cancer receiving radical resection of esophagus at our institution who were treated between October 2012 and July 2014 were collected and retrospectively analyzed.Of the 108 patients,51 patients underwent MIE（ MIE group） and 57 patients underwent OE（ OE group）.Surgical outcomes,oncological outcomes and postoperative complications were compared between the 2 groups.Results There was neither significant difference between the 2 groups in preoperative clinical characteristics nor in the median operative times and frequency of intraoperative blood transfusion.But between the MIE group and OE group,there were significant different in the amount of intraoperative blood loss（ 150.5 ± 30.4 vs 215.5 ± 40.4 mL）,the infused amount of intravenous fluids（ 2.2 vs 3.1 L）,the median length of ICU stay（ 1 vs 2 d） and median length of postoperative hospital stay（ 8 vs 10 d）.The median number of harvested lymph nodes and resection margins positive rate had no difference in the MIE group and OE group.The incidence of postoperative pulmonary complications were significantly lower in the MIE group than OE group（ 2 vs 25 cases,3.9% vs 43.8%）.Conclusion MIE not only has equivalent effect in oncological outcomes as OE,but also is superior to the latter in reducing length of hospital stay,intraoperative blood loss and postoperative pulmonary complications.

关 键 词：食管肿瘤 腔镜手术 开放手术 临床疗效 

分 类 号：R181.32[医药卫生—流行病学] R730.56[医药卫生—公共卫生与预防医学]