食管癌VATS切除术与开胸切除术术后并发症及预后比较  

Comparison of postoperative complications and prognosis between VATS resection and thoracic resection in treatment of esophageal carcinoma

作　　者：李雪益 沃西文[1] 童莉[1] 李颖[1] 龚文清[1] 张明灿[1] 

机构地区：[1]解放军324医院心胸外科,重庆400020

出　　处：《西南国防医药》2015年第5期496-498,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的比较分析电视辅助胸腔镜手术（VATS）及开胸手术对食管癌患者术后并发症及预后的影响。方法回顾性分析本院2010年1月~2014年12月经过手术治疗的食管癌患者40例,其中20例患者采用VATS术治疗,20例患者采用开胸术治疗,对比分析两组患者的术后并发症及预后。结果 VATS组术后疼痛时间、下床时间、进水时间及住院时间均明显短于开胸组（P〈0.01）。VATS组术后主要并发症的发生率是：心律失常5.0%,肺部感染10.0%、颈部吻合口瘘5.0%,总发生率为20.0%;而开胸组是：心律失常10.0%,肺部感染35.0%、颈部吻合口瘘10.0%,总发生率为55.0%。VATS组术后并发症总发生率明显低于开胸组（P〈0.05）。术后随访24个月,两组间存活率比较差异无统计学意义（P〉0.05）。结论 VATS食管癌切除术可显著降低术后并发症发生率,且术后恢复快,但尚不能提高患者的远期存活率。Objective To compare the effect of postoperative complications and prognosis between video-assisted thoraeoseopie surgery （VATS） resection and thoracic resection in treatment of esophageal carcinoma, Methods A retrospective analysis was made on the data about 40 patients with esophageal carcinoma who received operation from Jan. 2010 to Dec. 2014. VATS resection and thoracic resection was performed on every 20 patients respectively, the postoperative complications and prognosis were compared. Results The postoperative pain time, bed time, water drinking time and hospitalization time in VATS group were significantly shorter than those in thoracotomy group （P 〈 0.01）. The incidences of main postoperative complications in VATS group： arrhythmia： 5.0%; pulmonary infection： 10.0%; anastomotic fistula： 5.0%; overall incidence： 20.0%. The incidences of main postoperative complications in thoracotomy group： arrhythmia： 10.0%; pulmonary infection： 35.0%; anastomotic fistula： 10.0%; overall incidence： 55.0%. The overall incidence of postoperative complications in VATS group was significantly lower than that in thoracotomy group （P 〈 0.05）. Patients were followed up for 24 months, during which the survival rate between the two groups have no significant difference （P 〉 0.05）. Conclusion VATS can significantly reduce the incidence of postoperative complications in treatment of esophageal carcinoma; it can ensure rapid postoperative recovery, but still cannot improve the long-term survival of the patients.

关 键 词：电视辅助胸腔镜 开胸手术 食管癌 术后并发症 

分 类 号：R735.1[医药卫生—肿瘤]