胸腹腔镜联合食管癌切除与传统三切口食管癌切除的临床对比研究  

Comparison of the clinical effects of thoracic laparoscopy combined with resection of esophageal carcinoma and conventional three incision resection of esophageal carcinoma

作　　者：马晓林[1] 陈允清[1] 尹肇军 王建 张林浩[2] Ma Xiaolin;Chen Yunqing;Yin Zhaojun;Wang Jian;Zhang Linhao(Department of Surgery,Shanxi Provincial Cancer Hospital,Taiyuan,Shanxi 030013,China;Department of ICU,Shanxi Provincial Cancer Hospital,Taiyuan,Shanxi 030013,China)

机构地区：[1]山西省肿瘤医院外科特需病区,山西省太原030013 [2]山西省肿瘤医院ICU,山西省太原030013

出　　处：《中国基层医药》2018年第15期1905-1908,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 对比分析胸腹腔镜联合食管癌切除与传统三切口食管癌切除的临床效果.方法 选择2012年1月至2016年1月在山西省肿瘤医院接受食管癌切除术的患者62例,依据手术方式不同将患者分为腔镜组（28例）和传统组（34例）,分别接受胸腹腔镜联合食管癌切除术和三切口食管癌切除术,记录术中出血量、淋巴结清扫数目和术后第1天引流量、24 h呼吸机使用情况及气管切开例数,出院时记录并对比两组患者住院时间、闭式引流时间及术后并发症发生情况.结果 腔镜组手术时间、术中出血量、引流量、闭式引流时间和住院时间分别为（3.22 ±0.64）h、（218.20 ±45.42）mL、（235.67 ±42.15）mL、（3.32 ±1.81）d、（14.28 ± 2.53）d,均显著优于传统组的（4.52 ±1.11）h、（407.42 ±50.06）mL、（321.71 ±37.82）mL、（5.16 ±1.78）d、（17.35 ±4.38）d,差异均有统计学意义（t＝5.764、15.438、8.465、4.020、3.448,均P＜0.05）;腔镜组肺部感染、肺不张发生率分别为3.57%、0.00%,显著低于传统组的23.53%、17.65%（χ2＝4.929、5.471,均P＜0.05）;腔镜组24 h呼吸机使用率及气管切开率均为0.00%,显著低于传统组的23.53%、14.71%（ χ2＝7.564、4.479,均P＜0.05）.结论 胸腹腔镜联合食管癌切除术清扫淋巴结彻底、手术安全可靠,与传统术式相比具有创伤小、并发症发生率低、恢复快等优点,值得进一步推广使用.Objective To analyze and compare the curative effect of thoracic laparoscopy combined with resection of esophageal carcinoma and conventional three incision resection of esophageal carcinoma .Methods From January 2012 to January 2016,sixty-two patients received esophageal cancer resection in Shanxi Provincial Cancer Hospital were selected in the research.The patients were divided into laparoscopic group （28 cases） and traditional group（34 cases） according to surgical methods ,and they were treaded with thoracic laparoscopy combined with resection of esophageal carcinoma and three incision resection of esophageal carcinoma ,respectively.The amount of blood loss , the number of lymph node dissection ,the postoperative 1d flow,the ventilator use of 24h and the number of tracheotomy were recorded.The time of hospitalization,the time of closed drainage and the incidence of postoperative complications were recorded and compared between the two groups at discharge time.Results The operative time,amount of blood loss,drainage volume,drainage time and hospitalization time of the laparoscopic group were （3.22 ±0.64）h,（218.20 ± 45.42）mL,（235.67 ±42.15）mL,（3.32 ±1.81）d,（14.28 ±2.53）d,respectively,which were significantly lower than those of the traditional group [（4.52 ±1.11）h,（407.42 ±50.06）mL,（321.71 ±37.82）mL,（5.16 ±1.78）d, （17.35 ±4.38）d,t＝5.764,15.438,8.465,4.020,3.448,all P＜0.05].The incidence rates of pulmonary infection and atelectasis in the laparoscopic group were 3.57% and 0.00%,respectively,which were significantly lower than those in the traditional group （23.53% and 17.65%,χ2＝4.929,5.471,all P＜0.05）.The ventilator -assisted breathing rate and postoperative tracheotomy rate of the laparoscopic group were both 0.00%,which were significantly lower than those of the traditional group （23.53%and 14.71%,χ2＝7.564,4.479,all P＜0.05）.Conclusion It is safe and reliable to complete lymph node dissection and surgical treatment of thoracic laparo

关 键 词：食管肿瘤 胸腔镜检查 腹腔镜检查 食管切除术 

分 类 号：R735.1[医药卫生—肿瘤]