胸腔镜手术切除胸段食管癌患者的淋巴结清扫程度和手术并发症观察  

Data observation of lymph node cleaning and operative complication rate of thoracoscope surgery on patients with thoracic segment esophageal cancer

作　　者：熊秀娥[1] 徐鹏[2] 庞一雄[1] 朱琳燕[3] 

机构地区：[1]武汉科技大学附属孝感医院心胸整复科,432000 [2]武汉科技大学附属孝感医院CT室,432000 [3]鄂东医疗集团黄石市中心医院湖北理工学院附属医院肿瘤内科

出　　处：《中国综合临床》2017年第6期534-538,共5页Clinical Medicine of China

摘　　要：目的 比较胸段食管癌经胸腔镜手术切除和常规开胸手术切除胸段食管癌患者的淋巴结清扫程度和手术并发症发生率.方法 选取我院2012年8月至2014年8月收治的经胸腔镜手术治疗的胸段食管癌患者62例,设为胸腔镜组,选取同期行常规开胸手术治疗的胸段食管癌患者62例作为对照组.比较两组患者胸部清扫淋巴结总数、清扫淋巴结组数,并比较两组患者手术时间、术中出血量、放置胸管时间、术后住院时间等围手术期情况.所有患者均随访1年以上,比较两组患者在随访期内肺部感染、气胸、肺不张、喉返神经损伤、吻合口瘘等术后并发症发生情况,并比较两组患者预后情况.结果 胸腔镜组患者胸部清扫淋巴结总数（13.36±3.28）个、淋巴结总组数（3.35±0.84）个,对照组分别为（14.22±2.78）、（3.58±0.75）个,两组比较差异均无统计学意义（t值分别为1.57、1.61,P均＞0.05）;胸腔镜组手术时间[（314.63±38.72） min]、术中出血量[（205.73±114.38） ml]、放置胸管时间[（6.83±1.92）d]、术后住院时间[（18.47±5.36）d]均低于对照组[分别为（217.46±41.54） min、（345.72±175.62） ml、（10.04±2.41）d、（22.65±6.84）d],两组比较差异均有统计学意义（t值分别为13.47、5.26、8.20、3.79,P均＜0.05）;胸腔镜组随访期内肺部感染、肺不张发生率分别为4.8％ （3/62）、1.6％（1/62）,显著低于对照组[17.7％（11/62）、11.3％（7/62）],两组比较差异均有统计学意义（x2值分别为5.15、4.81,P均＜0.05）;胸腔镜组与对照组患者在术后随访期内的病死率分别为3.2％（2/62）、8.1％（5/62）,复发率分别为11.3％（7/62）、14.5％（9/62）,两组比较差异均无统计学意义（x2值分别为1.36、0.29,P均＞0.05）.结论 在胸段食管癌手术中,经胸腔镜手术在淋巴结清扫程度中与常规开胸手术相近,但可缩短住院时间,降低术中出血量、置管Objective To analysis the difference of lymph node cleaning and operative complication rate between thoracoscope surgery and routine thoracotomy on patients with thoracic segment esophageal cancer.Methods A summary of 62 patients with thoracic segment esophageal cancer in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from August 2012 to August 2014,who were carried with thoracoscope surgery,were randomly chosed and designed as the thoracosc0Pe group,and 62 patients with thoracic segment esophageal cancer over the same period,carried out with routine thoracotomy,were designed as the control group.All the clinical data of the two groups were collected.The total of thoracic lymph node cleaned and the group of thoracic lymph node cleaned were compared between the two groups.The operation time,intraoperative blood loss,chest tube placement time and postoperative hospital duration were collected and compared.All the patients were followed up at least for one year.The incidence of postoperative complications such as pulmonary infection,pneumothorax,atelectasis,recurrent laryngeal nerve injury and anastomotic leakage in the follow-up period were compared.The follow-up time,mortality and recurrence rate were compared.Results The total of thoracic lymph node cleaned（13.36±3.28） and the group of thoracic lymph node cleaned（3.35±0.84） in the thoracoscope group were lower then these of the control group （（14.22± 2.78） and （3.58±0.75））,but with no statistical difference （t =1.57,1.61,P〉 0.05）.The operation time of the thoracoscope group（（314.63±38.72） min） were higher then that of the control（（217.46±41.54） min）,and the intraoperative blood loss （（205.73 ± 114.38） ml）,chest tube placement time （（6.83 ± 1.92） d） and postoperative hospital duration（（18.47±5.36） d） of the thoracoscope group were remarkably lower then these of the control （（345.72 ±175.62） m1,（10.04±2.41） d,（22.65±6.84） d,t=13.47,5.26,8.20,3.79,P

关 键 词：食管癌 胸腔镜 淋巴结清扫 术后并发症 

分 类 号：R735.1[医药卫生—肿瘤]