电视胸腔镜辅助小切口管状胃成形在食管癌根治术中的应用  

Application of video-assisted thoracoscopic gastric tubes in esophageal carcinoma with a small incision

作　　者：梁风[1] 李振龙[1] 侯海利 刘玉杰[1] 王志[1] 

机构地区：[1]武警北京总队第三医院胸外科,100141 [2]武警北京总队第三医院保健科,100141

出　　处：《武警医学》2017年第10期999-1001,1004,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨电视胸腔镜辅助小切口联合管状胃成形在食管癌根治术的临床应用。方法对本院2012-07至2015-12共95例电视胸腔镜辅助小切口管状胃食管癌根治术患者的资料进行总结分析,根据手术时间、术中出血量、术后并发症、术后肺功能变化及术后生活质量情况,评价该手术方式临床应用价值。结果 95例中,手术切口长度(7.5±2.2)cm;手术时间(210±26)min;术中出血量(285.0±106.5)ml;住院时间(9.2±1.5)d;术后并发症发生率为27.4%,第1位为消化系统并发症,为15.8%;术后1个月用力肺活量(2.75±0.80)L,第1秒用力呼气容积(1.95±0.34)L,与术前相比无明显下降(P>0.05)。术后3个月自我感觉良好为69.5%(66/95)、相当27.4%(26/95)、较差3.2%(3/95)。结论与传统术式及全胸腹腔镜术式相比,电视胸腔镜辅助小切口联合管状胃食管癌根治术具有术中操作难度较小、创伤小、并发症较少、费用较少、生活质量更高等优势。Objective To study the applicability of the video-assisted thoracoscopic gastric tube in esophagectomy with a small incision. Methods Clinical data about 95 esophageal patients who had undergone esophagectomy with a small incision and gastric tubes between July 2012 and December 2015 were retrospectively analyzed. The applicability of this approach was assessed according to the duration of operation, intraoperative blood loss, postoperative complications and pulmonary function. Results The incision was （7.5 ±2.2 ） cm long, the duration of operation （210± 26 ） min, the intraoperative blood loss （285.0 ± 106.5 ） ml. hospital stay （9.2 ±1.5 ） d, and the incidence of postoperative complications was 27.4%. The incidence of digestive complications was the highest,accouting for 15.8% of the total. The forced vital capacity was （2.75 ±0. 80）L and forced expiratory volume 1 second was（ 1.95 ± 0.34）L. Three months after operation, the quality of life of these patients was better than one month after operation （ P 〈 0.05 ）. Conclusions Radi- cal esophagectomy with video-assisted thoracoscopic small incision and gastric tubes is characterized by user-friendliness, less trauma, fewer complications, lower expenses, and better quality of life compared with traditional surgical approaches and other approaches.

关 键 词：食管肿瘤 食管切除术 电视胸腔镜 小切口 管状胃 

分 类 号：R655.4[医药卫生—外科学]