胸腹腔镜联合食管癌根治术治疗老年食管癌的临床疗效及预后分析  

Analysis of Clinical Effects and Prognosis of Thoracic Laparoscopic Combined Esophageal Radical Operation for Elderly Patients with Esophageal Cancer

作　　者：王军岐 杨智[1] 付小伟[1] 仝瑞锋[1] 刘明伟[1] 

机构地区：[1]陕西省宝鸡市中心医院胸外科,陕西宝鸡721008

出　　处：《现代生物医学进展》2015年第15期2888-2890,2903,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨胸、腹腔镜联合手术治疗老年食管癌的临床疗效及对预后影响。方法:选取我院2012年2月-2013年7月收治的72例老年食管癌患者,采用字数表法随机分成联合组和传统组,各36例;传统组给予传统开腹开胸手术,联合组则采用胸腹腔镜联合根治术治疗。随访1年,比对两组患者手术临床指标及术后并发症发生率、复发率、死亡率及生活质量。结果:两组手术时间及淋巴结清扫量对比明显差异(P>0.05);联合组创口长度、住院时间及出血量均明显低于传统组,住院费用高于传统组,两组比较差异有统计学意义(P<0.05);联合组术后转ICU者1例、并发症者2例,与传统组的3例和5例对比无统计学意义(P>0.05);联合组复发1例,死亡1例,传统组复发1例、转移1例,死亡1例,两组对比无明显差异(P>0.05);术后联合组VAS评分明显低于传统组,两组比较具有统计学意义(P<0.05);联合组生理机能、躯体疼痛及精力评分明显高于传统组(P<0.05),其余5项评分对比差异无统计学意义(P>0.05)。结论:胸、腹腔镜联合食管癌根治术治疗老年食管癌患者临床疗效显著,并发症低,预后良好,值得在老年食管癌患者中推广。Objective： To investigate the effect of thoracic laparoscopic combined radical operation for elderly patients with esophageal cancer and its influence on prognosis. Methods： 72 cases of elderly patients with esophageal cancer in our hospital from February 2012 to July 2013 were randomly divided into combined group and traditional group by word table method, 36 cases in each. The traditional group was given conventional laparotomyand thoracotomy, and the combined group received thoracic laparoscopic com- bined radical operation treatment. 1 years of follow-up, the clinical index and postoperative complication rate, recurrence rate, mortality and quality of life were compared between two groups. Results： There was no statistical difference in operation time and number of lymph node dissection between the two groups（P〉0.05）. The wotmd length, hospitalization time and amount of bleeding of the combined group were significantly lower than those of the traditional group. The hospitalization expenses of traditional group was significantly lower than that of the combined group （P〈0.05）. After operation,1 cases transferred to ICU, 2 cases with complications in combined group, compared with 3 cases and 5 cases in traditional group, there was no statistical significance （P〉0.05）; Postoperative VAS scores of the combined group were significantly lower than that of the traditional group （P〈0.05）; The physiological functions, physical pain and men- tal scores of the combined group were significantly higher than those of the traditional group （P〈0.05）, and others of 5 dimensions had no difference compared with the traditional group （P〉0.05）. Conclusion： Thoracic laparoscopic combined radical operation for elderly pa- tients with esophageal cancer has obvious curative effect, with low complications and well prognosis, it＇s worthy of promotion of esophageal carcinoma in elderly patients.

关 键 词：胸腹腔镜 根治术 老年人 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]