全胸腔镜下食管癌切除术与常规手术的对比研究  

Video-assisted thoracic surgery vs conventional open surgery for esophageal cancer

作　　者：曹彬[1] Cao Bin(Department of Cardiothoracic Surgery,Nanjing Drum Tower Hospital,Nanjing University Medical College,Nanjing,Jiangsu 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院南京鼓楼医院心胸外科,210008

出　　处：《中华生物医学工程杂志》2020年第1期67-70,共4页Chinese Journal of Biomedical Engineering

摘　　要：目的探讨全胸腔镜下食管癌切除术较常规开胸手术的优势。方法回顾性分析2010年3月至2016年2月于本院行食管癌切除术患者的临床资料,按手术方式不同分为两组:全胸腔镜下食管癌切除术(微创组)102例,常规开胸手术(对照组)48例,比较两组临床疗效及并发症发生情况。结果两组手术时间、清扫淋巴结数目比较,差异无统计学意义(均P>0.05)。微创组术中出血量、术后3 d引流量、术后转入ICU例数及术后住院时间均显著优于对照组(均P<0.05)。并发症比较显示,微创组肺部感染、切口液化的发生率均显著低于对照组(均P<0.05);而两组吻合口漏、声音嘶哑、乳糜胸及胃排空不良的发生率组间比较,差异均无统计学意义(均P>0.05)。两组术后1年生存率及复发率比较,差异均无统计学意义(均P>0.05)。结论全胸腔镜下食管癌切除术具有出血少、恢复快、并发症少、淋巴结清扫彻底等优点,是一种安全、有效的食管癌外科治疗手段。Objective To summarize the advantages of video-assisted thoracic surgery(VATS)for esophageal cancer resection compared with conventional thoracotomy.Methods The clinical data of patients undergoing esophageal cancer resection in our hospital between March 2010 and February 2016 were reviewed.The subjects were divided into two groups according to surgical options:102 patients with esophageal cancer undergoing VATS as the minimally invasive group,and 48 undergoing open thoracotomy as the control group.The clinical efficacy and complications were compared between the two groups.Results There was no significant differences in the operation time and number of dissected lymph nodes between the two groups(both P>0.05).The intraoperative blood loss,3-day postoperative drainage,postoperative transfer to ICU,and postoperative length of hospital stay were significantly favorable in the minimally invasive group compared with the control group(all P<0.05).The incidence rates of pulmonary infection and fat liquefaction of wound were significantly lower in the minimally invasive group than those in the control group(both P<0.05).The incidence of anastomosis leakage,hoarseness,chylothorax,and poor gastric emptying did not differ between the two groups(all P>0.05).There was no significant difference in the one-year survival and recurrence rate between the two groups(both P>0.05).Conclusion Resection of esophageal cancer via VATS is advantageous in less blood loss,rapid recovery,fewer complications,and radical dissection of lymph nodes,and therefore is a safe and effective surgical option for esophageal cancer.

关 键 词：食管肿瘤 胸外科手术 外科手术 微创性 电视胸腔镜手术 并发症 

分 类 号：R735[医药卫生—肿瘤]