胸腹腔镜联合用于食管癌微创手术的可行性及对肺功能的影响  

Feasibility of minimally invasive combined laparoscopic and thoracoscopic esophagectomy and its influence on pulmonary function

作　　者：饶新辉[1] 刘汉云[1] 梁锦崧[1] 张自正[1] 张焕荣[1] 

机构地区：[1]中山大学附属梅州市人民医院胸外科,广东梅州514031

出　　处：《海南医学院学报》2015年第9期1232-1234,共3页Journal of Hainan Medical University

基　　金：广东省梅州市科技计划项目(2012B07)~~

摘　　要：目的：探讨胸腹腔镜联合下食管癌微创手术对手术患者肺功能的影响及临床疗效。方法：回顾性分析2011年1月~2014年12月收治的并且病历资料完整的食管癌患者200例,其中采用胸腹腔镜联合下食管癌微创手术治疗的患者100例（观察组）,采用开放性手术食管癌治疗的患者100例（对照组）,对比两组患者手术指标、术后并发症、近期疗效及手术对患者肺功能的影响。结果：两组患者手术时间、清扫淋巴结数、术后并发症发生率比较差异无统计学差异（P〉0.05）,观察组术中出血量、胸管留置时间、住院时间均显著低于对照组（P〈0.05）;观察组术后第5天FEV1与治疗前比较差异无统计学意义（P〉0.05）,对照组显著低于治疗前（P〈0.05）;观察组治疗后FEV1/FVC显著高于对照组（P〈0.05）;观察组手术前后PaO2、SaO2比较差异无统计学意义（P〉0.05）;对照组术后PaO2、SaO2显著低于术前（P〈0.05）。结论：胸腹腔镜联合下食管癌微创手术疗效确切,且对呼吸功能无明显影响,较传统开放性手术治疗方案具有显著优势。Objective：To investigate the feasibility of minimally invasive combined laparoscopic and thoracoscopic esophagectomy and its influence on lung function.Methods：Data of 200 esophageal cancer patients were retrospectively analyzed,of which 100 underwent minimally invasive combined laparoscopic and thoracoscopic esophagectomy（observation group）and 100 underwent open surgery（control group）,Operation indicators,postoperative complications,short-term and long-term curative effects as well as influence of the surgery on pulmonary function were compared.Results：No significant difference in operation time,number of removed lymph nodes,incidence of postoperative complications were observed between the two groups（P〉0.05）.Volume of intraoperative blood loss,chest tube indwelling time,length of hospital stay of the observation group were significantly less or shorter than that of the control group（P 0.05）.Five days after undergoing the surgery,FEV1 of the observation group was not significantly different compared with that before treatment,while for the control group,it was significant lower than that before the treatment（P〉 0.05）.After treatment,FEV1/FVC of the observation group was significant higher than that of the control group（P〈0.05）.After treatment,no significant difference in PaO2,SaO2 was found in observation group comparing with that after treatment（P〈0.05）.For the control group,PaO2,SaO2 were significant diseased after the treatment.Conclusion：Minimally invasive combined laparoscopic and thoracoscopic esophagectomy shows good curative effects without severely affecting pulmonary function.It shows advantages over open surgery.

关 键 词：胸腹腔镜 食管癌 微创手术 肺功能 

分 类 号：R730.5[医药卫生—肿瘤]