新辅助化放疗后微创食管癌切除术安全性和可行性分析  

Feasibility and Safety Analysis of Minimally Invasive Esophagectomy Following Neoadjuvant Chemoradiation Therapy

作　　者：杨鲸蓉[1,2] 朱捷[1] 叶仕新[2] 连铎煌[2] 曾志勇[1,2] 

机构地区：[1]第二军医大学福州临床医学院,上海200433 [2]南京军区福州总医院胸心外科,福州350025

出　　处：《医学综述》2017年第17期3521-3524,共4页Medical Recapitulate

摘　　要：目的探讨新辅助化放疗后微创食管癌切除术的可行性和安全性。方法回顾性分析2013年1月至2015年12月南京军区福州总医院心胸外科行新辅助化放疗后成功完成食管癌切除术的96例患者的临床资料。根据手术方式不同分为微创组(n=53)和开放组(n=43)。微创组患者行微创Mckeown食管癌切除术,开放组患者行传统开放Mckeown食管癌切除术。分析两组患者的临床资料、手术时间、术中出血量、淋巴结清扫数及术后并发症情况。结果微创组术中出血量少于开放组[(208±82)m L比(243±108)m L,P<0.05]。两组手术时间、平均清扫淋巴结数、ICU时间和平均住院时间比较差异无统计学意义(P>0.05)。两组并发症发生率和住院病死率比较差异无统计学意义(P>0.05)。结论食管癌新辅助化放疗后行微创Mckeown食管切除术在技术上是安全可行的,术中出血少,不增加术后并发症及病死率,可以达到开胸手术的治疗效果。Objective To investigate the feasibility and safety of minimally invasive McKeown esophagectomy following neoadjuvant chemoradiatian therapy. Methods The records of 96 esophageal cancer patients who received esophageetomy following neoadjuvant chemoradiation therapy in Fuzhou General Hospital of Nanjing Military Command between Jau. 2013 and Dec. 2015 were retrospectively analyzed. 53 cases given minimally invasive esophagectomy were included in the minimally invasive group, and 43 cases given traditional esophagectomy were included in the open group. The demographics and clinicopathological data, the surgery duration, intraoperative bleeding,lymph node clearance and postoperative complications were analyzed. Results The average of blood loss of the minimally invasive group was less than that of the open group [ （208 ±82） mL vs （243 ± 108） mL,P 〈0.05]. The operation time,number of lymph nodes,ICU stay and postoperative stay of the two groups had no statistically significant differences （ P 〉 0.05 ）. There were no significant differences between the two groups in the incidence of complications and in-hospital mortality （ P 〉 0.05 ）. Conclusion Minimally invasive esophagectomy following neoadjuvant chemoradiatian therapy for treating esophageal cancer is safe and feasible to achieve favorable early outcomes, with tess intraoperative bleeding, no increase of postoperative complications and mortality, and can achieve the therapeutic effect of open chest surgery.

关 键 词：食管癌 新辅助化放疗 微创 

分 类 号：R735.1[医药卫生—肿瘤]