游离食管前实施喉返神经淋巴结清扫对胸段食管癌胸腔镜根治术患者预后的影响  

Effect of recurrent laryngeal nerve lymph node dissection before esophageal dissociation on prognosis in patients undergoing thoracoscopic radical resection of thoracic esophageal cancer

作　　者：李林浦 李文忠 罗仕云 Li Linpu;Li Wenzhong;Luo Shiyun(Gastroenterothoracic Surgery Department of Chengdu 363 Hospital,Chengdu,611700,Sichuan,China)

机构地区：[1]成都三六三医院胃肠胸外科,四川成都611700

出　　处：《西藏医药》2024年第4期15-17,共3页Tibetan Medicine

摘　　要：目的目的探究游离食管前实施喉返神经淋巴结清扫对胸段食管癌胸腔镜根治术患者预后的影响。方法方法选择入我院行胸腔镜食管癌根治术的80例食管癌患者为研究对象,随机数表法分为实验组和对照组各40例。实验组术中采用先清扫喉返神经淋巴结,再游离食管顺序,对照组以先游离食管,再行喉返神经淋巴结清扫顺序操作。比较两组治疗相关指标(手术时间、腹腔引流时间、胸管留置时间、住院时间)差异;比较术后1个月内并发症(喉返神经损伤、吻合口瘘、心律失常、呼吸衰竭、乳糜胸)发生率。结果结果实验组手术时间明显高于对照组(P<0.05),两组腹腔引流时间、胸管留置时间、住院时间(P>0.05);术后1个月内,实验组喉返神经损伤发生率明显小于对照组(均P<0.05);两组心律失常、吻合口瘘、呼吸衰竭、乳糜胸等发生率(均P>0.05)。结论结论胸腔镜食管癌根治术中采用先喉返神经淋巴结清扫,再游离食管操作,可降低并发症发生风险,利于患者术后恢复。Objective To explore the effect of recurrent laryngeal nerve lymph node dissection before esophageal dissociation on the prognosis in patients undergoing thoracoscopic radical resection of thoracic esophageal cancer.Methods 80 patients with esopha-geal cancer who underwent thoracoscopic radical resection of esophageal cancer in the hospital were selected as the study subjects,and were divided into experimental group and control group by the random number table method,with 40 cases in each group.The experimental group adopted recurrent laryngeal nerve lymph node dissection and then dissociated the esophagus,and the control group firstly dissociated the esophagus and then performed recurrent laryngeal nerve lymph node dissection.The differences in treat-ment-related indicators(surgical time,abdominal drainage time,chest tube indwelling time,hospital stay)and incidence rates of complications(recurrent laryngeal nerve injury,anastomotic fistula,arrhythmia,respiratory failure,chylothorax)within 1 month af-ter surgery were compared.Results The surgical time in experimental group was significantly longer than that in control group(P<0.05),but there were no statistically significant differences in abdominal drainage time,chest tube indwelling time and hospital stay between the two groups(P>0.05).The incidence rate of recurrent laryngeal nerve injury in experimental group was significantly low-er than that in control group(P<0.05).There were no statistical differences in the incidence rates of arrhythmia,anastomotic fistula,respiratory failure and chylothorax between the two groups(all P>0.05).Conclusion During thoracoscopic radical resection of esophageal cancer,recurrent nerve lymph node dissection followed by esophageal dissociation can reduce the risk of complications and facilitate the postoperative recovery.

关 键 词：胸腔镜 食管癌根治术 喉返神经 淋巴结清扫 食管游离 

分 类 号：R735.1[医药卫生—肿瘤]