联合麻醉下行胸腹腔镜微创手术治疗食管癌的效果观察  

Effect of Combined Thoracoscopic and Laparoscopic Minimally Invasive Surgery on Esophageal Cancer

作　　者：李淑芬[1] LI Shufen(Department of Anesthesiology,Xiaogan Central Hospital,Hubei Province,Xiaogan Hubei 432000,China)

机构地区：[1]湖北省孝感市中心医院麻醉科,湖北孝感432000

出　　处：《中国继续医学教育》2019年第4期80-82,共3页China Continuing Medical Education

摘　　要：目的评价对于食管癌患者在联合麻醉下行胸腹腔镜微创手术治疗的效果。方法选取我院2014年1月—2015年1月收治的食管癌患者80例,利用随机数字表将其分为对照组和腔镜组,每组40例。对照组实施联合麻醉下开胸手术,腔镜组实施联合麻醉下胸腹腔镜微创手术。比较两组的围术期相关指标,并对比两组术后住院期间的并发症发生率,术后随访3年,对比两组的生存率。结果两组的手术用时差异不显著(P> 0.05),腔镜组的术中出血量、术后胸腔引流量少于对照组(P <0.05),腔镜组淋巴结清扫数目多于对照组(P <0.05),腔镜组胸管拔除时间、住院时间均短于对照组(P <0.05);术后并发症发生率比较腔镜组更低(P <0.05);术后随访3年,观察组的生存率与对照组比较无显著差异(P> 0.05)。结论在联合麻醉下行胸腹腔镜微创手术治疗食管癌的效果好,并具有创伤小、恢复快、术后并发症少的优势,对患者的远期生存率无明显影响,是一种安全可行的手术方式。Objective Objective To evaluate the effect of minimally invasive thoracoscopic surgery under combined anesthesia for esophageal cancer.Methods Eighty patients with esophageal cancer admitted to our hospital from January 2014 to January 2015 were randomly divided into control group and endoscopic group with 40 cases in each group.The control group underwent thoracotomy under combined anesthesia,while the endoscopic group underwent minimally invasive thoracoscopic surgery under combined anesthesia.The perioperative related indexes were compared between the two groups,and the incidence of postoperative complications during hospitalization was compared between the two groups.The survival rates of the two groups were compared after 3 years follow-up.Results There was no significant difference in operation time between the two groups(P >0.05).The amount of intraoperative bleeding and postoperative thoracic drainage in the endoscopic group were less than those in the control group(P<0.05).The number of lymph node dissection in the endoscopic group was more than that in the control group(P<0.05).The incidence was lower in the endoscopic group(P<0.05),and there was no significant difference in the survival rate between the endoscopic group and the control group after 3 years of follow-up(P >0.05).Conclusion Minimally invasive thoracoscopic surgery under combined anesthesia for esophageal cancer has the advantages of less trauma,rapid recovery and fewer postoperative complications.It has no significant effect on the long-term survival rate of patients.It is a safe and feasible operation method.

关 键 词：联合麻醉 食管癌 胸腔镜 腹腔镜 微创手术 并发症 生存率 

分 类 号：R659[医药卫生—外科学]