胸腹腔镜联合食管癌根治术与开放三切口手术临床效果对比  

Comparison between thoracoscopy combined with laparoscopic and open three incision radical resection of esophageal cancer

作　　者：李浩然 徐华明[2] 赵晓华[2] 张振亮[2] 王如坤 隽兆东[1] LI Haoran1, XU Huaming2, ZHAO Xiaohua2 , ZHANG Zhenliang2, WANG Rukun2, JUAN Zhaodong1(1. Department of Surgery, Weifang Medical University, Weifang 261053, China ; 2. Department of Thoracic Surgery, the Affiliated Hospital of Weifang Medical University)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊医学院附属医院胸外科

出　　处：《潍坊医学院学报》2018年第1期70-72,共3页Acta Academiae Medicinae Weifang

摘　　要：目的分析及对比胸腹腔镜联合食管癌根治术与开放三切口手术的临床效果及术后恢复情况。方法回顾性选取2015年7月~2016年9月收治的食管癌患者共计50例,按照手术方式不同分为腔镜组(E组,22例)及开放组(O组,28例)。比较两组手术时间、术中出血量、淋巴结清扫数、术后胸腔及纵隔引流情况、术后并发症、住院时间等指标。结果本次研究的病例均顺利完成手术,腔镜组中无中转开胸情况。腔镜组手术时间个体间差异较大,两组手术时间对比,差异无统计学意义(P>0.05),术中出血量腔镜组明显少于开放组(P<0.05),淋巴结清扫数各组差别不明显(P>0.05),腔镜组术后24h引流量少于开放组(P<0.05),术后并发症发生率腔镜组低于开放组(P<0.05),腔镜组住院时间较开放组短(P<0.05)。结论胸腹腔镜联合食管癌根治术在临床中可以达到与开放三切口手术相同的治疗效果,且腔镜手术患者手术创伤小,术后恢复快,并发症发生率低,可以作为首选治疗方案在临床中应用。Objective To analyze and compare the clinical effects and postoperative recovery between thoracoscopy combined with laparoscopy and open three incision resection of esophagus cancer. Methods A total of 50 patients with esophageal cancer admitted to the hospital from July 2015 to September 2016 were selected retrospectively. They were divided into endoscopic group（ E Grope,22 cases）and open group（ O Grope,28 cases） according to the operation methods. Then the clinical data（ operation time,intraoperative bleeding,lymph nodes,postoperative pleural and mediastinal drainage,postoperative complications,hospitalization time,etc.） were analised. Results The cases of this study were successfully completed,and there was no transfer to thoracotomy in the endoscopic group. Limited by the objective factors,the difference of individual endoscopic operation time between each sugeron was obvious,but the difference of the operation time between the two groups was not statistically significant（ P〉0. 05）,the volume of intraoperative hemorrhage in laparoscopic group was significantly less than the open group（ P〈0. 05）,lymph nodes were not significantly different between the two groups（ P〉0. 05）,postoperative drainage volume was less than the open group（ P〈0. 05）,the incidence of postoperative complications and hospitalization time of laparoscopic group was lower than the open group（ P〈0. 05）. Conclusion Thoracoscopic combined with laparoscopic radical resection of esophageal cancer can achieve the same therapeutic effect as open three incision surgery,but the endoscopic surgery with mini-invasive can get faster postoperative recovery and lower complication rate. It can be used as the preferred treatment in clinical practice.

关 键 词：食管癌 胸腹腔镜联合 三切口手术 

分 类 号：R735.1[医药卫生—肿瘤]