三切口食管癌切除术:胸腔镜与开放手术的术后并发症分析  

Analysis of postoperative complications for McK eown esophagectomy: minimally invasive versus open esophagectomy

作　　者：孙超[1] 石维平[1] 吕小夏[1] 邹辉[1] 束余声[1] 陆世春[1] 金卫国[1] 王霄霖 

机构地区：[1]江苏省苏北人民医院胸心外科,扬州225001

出　　处：《中华腔镜外科杂志（电子版）》2016年第6期354-357,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的比较胸腔镜三切口食管癌切除术(minimally invasive eaophagectomy,MIE)及开放三切口食管癌切除术(open esophagectomy,OE)术后并发症的发生情况,评判胸腔镜是否可以减少患者术后并发症的发生。方法采用回顾性分析研究,选取2015年1月至2016年3月间扬州市苏北人民医院胸心外科收治的接受三切口食管癌手术患者为研究对象,其中MIE患者153例(MIE组),OE患者178例(OE组)。比较两组患者的手术时间、术中出血量、淋巴结清扫数目及术后常见并发症的发生情况并进行统计分析。结果两组患者均顺利完成手术,无围手术期死亡。与OE组相比,MIE组的术中出血量明显减少[(123±38)ml vs(346±89)ml,P=0.000],清扫淋巴结数目增多[(29.2±6.3)枚vs(25.5±5.8)枚,P=0.032],术后并发症总体减少(55.6%vs 86.5%,P=0.000),其中肺部感染发生率明显降低(8.4%vs 20.2%,P=0.003)。结论三切口食管癌根治术,胸腔镜较开放手术而言,可以减少术后并发症的发生,尤其是在减少肺部感染的发生上有明显优势。Objective To evaluate whether minimally invasive esophagectomy can reduce the incidence of postoperative complications compared with open thoracic surgery. Methods A total of 331 patients undergoing the McKeown esophagectomy were included in this study and divided into a thoracoscopic minimally invasive esophagectomy group （ MIE group, n = 153 ） and an open thoracic esophagectomy group （OE group,n = 178 ）. Postoperative complications were compared between the two groups. Results Compared with OE group, MIE group had a less amount bleeding [ （123±38）ml vs（346±89）,P=0. 000],more retrieved lymph nodes [ （ 29. 2 ± 6. 3 ） m （ 25. 5 ± 5. 8 ） , P = 0. 032 ） ] ,less total postoperative complications （55.6% vs 86. 5% ,P = 0. 000） and a lower incidence of pulmonary infection （8. 4% vs 20. 2% ,P = 0. 003 ） . Conclusions This observation study suggests that thoracoscopic minimally invasive esophagectomy can reduce the incidence of postoperative complications, especially better for the incidence of pulmonary infection.

关 键 词：胸腔镜 微创食管癌切除术 食管癌 并发症 

分 类 号：R735.1[医药卫生—肿瘤]