胸腹腔镜联合Mckeown手术与传统三切口手术治疗食管癌的疗效比较  

Comparison of the effect of thoracoscopy combined with laparoscopy Mckeown and traditional three incision surgery in radical resection of esophageal carcinoma

作　　者：吴伟斌[1] 曾贵青[1] 黄豪达[1] 吕文强[1] 

机构地区：[1]中山大学附属揭阳医院胸心外科,广东省揭阳522010

出　　处：《中国基层医药》2016年第2期268-271,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：比较胸腹腔镜联合Mckeown手术与传统三切口手术在食管癌根治术中的临床效果。方法选取300例经胃镜及病理检查确诊的食管癌患者，采用随机数字表法将患者分为观察组和对照组，每组150例。观察组患者采用胸腹腔镜联合 Mckeown 手术的治疗方案，对照组采用传统三切口手术的治疗方案。对比两组患者采用不同方案的手术时间、术中出血量、清扫淋巴结数目、术后胸腔引流管留置时间、并发症发生率、术后住院时间。结果观察组手术时间[（282±62）min]与对照组手术时间[（273±64）min]差异无统计学意义（P ＞0．05）。观察组清扫淋巴结数目（23．2±6．6）与对照组清扫淋巴结数目（21．6±6．4）比较，差异无统计学意义（P ＞0．05）。观察组术中出血量[（262．3±44．7）mL]、术后胸腔引流管留置时间[（7．6±1．6）d]、并发症发生率（16．7％）、术后住院时间[（10．5±2．5）d]明显小于对照组[（315．2±72．6）mL，（9．4±2．4）d，30％，（14±2）d]，差异有统计学意义（均 P ＜0．05）。结论胸腹腔镜联合 Mckeown 手术治疗食管癌效果与传统三切口手术相当，可减少术中出血量，减少并发症发生，缩短术后胸腔引流管留置时间、术后住院时间，值得临床推广。Objective To compare the effect of thoracoscopy combined with laparoscopy Mckeown and tradi- tional three incision surgery in radical resection of esophageal carcinoma. Methods 300 patients with esophageal cancer who confirmed diagnosis by gastroscopy and pathology, were randomly divided into the observation group and the control group, 150 patients in each group. The observation group was treated by thoracoscopy combined with lapa- roscopy Mckeown esophagectomy, and the control group was treated by traditional three incision surgery. The operation time, intraoperative blood loss, number of lymph node dissection, length of chest tube drainage, postoperative complica- tions, and length of postoperative hospital stay of the two groups were compared. Results There were no significant differences between the two groups in operating time [ （282 ±62） min vs. （273 ±64） min, P 〉 0.05 ], and number of lymph node dissection[ （23.2 ±6.6） vs. （21.6 ±6.4） ,P 〉0.05] ,and there were significant differences in intraop- erative blood loss [ （262.3 ± 44.7 ） mL vs. （ 315.2 ±72.6 ） mL, P 〈 0.05 ], length of chest tube drainage [ （ 7.6 ± 1.6） d vs. （9.4 ± 2.4） d,P 〈0.05 ] ,postoperative complications[ 16.7% vs. 30.0% ,P 〈 0.05 ], and length of hos- pital stay[ （10.5 ±2.5）d vs. （14.0 ±2.0）d,P 〈0.05]. Conclusion Thoracoscopy combined with laparoscopy Mckeown esophagectomy can achieve the same efficacy compared with the traditional approach, and it is worth popu- larizing in clinic for reducing intraoperative blood loss,length of chest tube drainage,postoperative complications, and length of hospital stay.

关 键 词：食管肿瘤 胸腔镜检查 腹腔镜检查 外科手术 

分 类 号：R735.1[医药卫生—肿瘤]