中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
9期
938-942
,共5页
刘宝兴%李印%秦建军%张瑞祥%刘先本%孙海波%刘士磊
劉寶興%李印%秦建軍%張瑞祥%劉先本%孫海波%劉士磊
류보흥%리인%진건군%장서상%류선본%손해파%류사뢰
食管肿瘤%食管次全切除术%胸腔镜%腹腔镜
食管腫瘤%食管次全切除術%胸腔鏡%腹腔鏡
식관종류%식관차전절제술%흉강경%복강경
Esophageal neoplasms%Sub-total esophagectomy%Thoracoscopy%Laparoscopy
目的 探讨胸腹腔镜联合食管次全切除术治疗食管癌的安全性和有效性.方法 回顾性分析2009年3月至2011年10月间在郑州大学附属肿瘤医院接受胸腹腔镜联合食管次全切除术的98例食管癌患者的临床资料.选择同期105例行常规三切口食管次全切除术的食管癌患者作为对照.结果 与常规三切口组相比,胸腹腔镜联合组患者术中出血量减少[(85.1±32.8) ml比(215.5±60.6) ml],术后住院时间缩短[(12.7±3.5)d比(16.9±4.5)d],术后肺炎[4.1％(4/98)比12.4％(13/105)]、肺不张[3.1％(3/98)比10.5％( 11/105)]、需要处理的胸腔积液[ 3.1％ (3/98)比10.5％(11/105)]、急性呼吸窘迫[1.0％(1/98)比7.6％(8/105)]及心律失常[4.1％(4/98)比12.4％(13/105)]等心肺系统并发症发生率下降,差异均有统计学意义(均P＜0.05).两组手术时间和淋巴结清扫数目的差异无统计学意义,术后吻合口瘘、脓胸、乳糜胸、二次开腹、二次开胸、声带麻痹、肾功能衰竭、胃排空障碍发生率及病死率的差异亦无统计学意义(均P＞0.05).结论 胸腹腔镜食管次全切除术治疗食管癌在技术上是安全可行的,在减少术中出血量、降低术后心肺系统并发症和缩短术后住院时间上具有优势.
目的 探討胸腹腔鏡聯閤食管次全切除術治療食管癌的安全性和有效性.方法 迴顧性分析2009年3月至2011年10月間在鄭州大學附屬腫瘤醫院接受胸腹腔鏡聯閤食管次全切除術的98例食管癌患者的臨床資料.選擇同期105例行常規三切口食管次全切除術的食管癌患者作為對照.結果 與常規三切口組相比,胸腹腔鏡聯閤組患者術中齣血量減少[(85.1±32.8) ml比(215.5±60.6) ml],術後住院時間縮短[(12.7±3.5)d比(16.9±4.5)d],術後肺炎[4.1％(4/98)比12.4％(13/105)]、肺不張[3.1％(3/98)比10.5％( 11/105)]、需要處理的胸腔積液[ 3.1％ (3/98)比10.5％(11/105)]、急性呼吸窘迫[1.0％(1/98)比7.6％(8/105)]及心律失常[4.1％(4/98)比12.4％(13/105)]等心肺繫統併髮癥髮生率下降,差異均有統計學意義(均P＜0.05).兩組手術時間和淋巴結清掃數目的差異無統計學意義,術後吻閤口瘺、膿胸、乳糜胸、二次開腹、二次開胸、聲帶痳痺、腎功能衰竭、胃排空障礙髮生率及病死率的差異亦無統計學意義(均P＞0.05).結論 胸腹腔鏡食管次全切除術治療食管癌在技術上是安全可行的,在減少術中齣血量、降低術後心肺繫統併髮癥和縮短術後住院時間上具有優勢.
목적 탐토흉복강경연합식관차전절제술치료식관암적안전성화유효성.방법 회고성분석2009년3월지2011년10월간재정주대학부속종류의원접수흉복강경연합식관차전절제술적98례식관암환자적림상자료.선택동기105례행상규삼절구식관차전절제술적식관암환자작위대조.결과 여상규삼절구조상비,흉복강경연합조환자술중출혈량감소[(85.1±32.8) ml비(215.5±60.6) ml],술후주원시간축단[(12.7±3.5)d비(16.9±4.5)d],술후폐염[4.1％(4/98)비12.4％(13/105)]、폐불장[3.1％(3/98)비10.5％( 11/105)]、수요처리적흉강적액[ 3.1％ (3/98)비10.5％(11/105)]、급성호흡군박[1.0％(1/98)비7.6％(8/105)]급심률실상[4.1％(4/98)비12.4％(13/105)]등심폐계통병발증발생솔하강,차이균유통계학의의(균P＜0.05).량조수술시간화림파결청소수목적차이무통계학의의,술후문합구루、농흉、유미흉、이차개복、이차개흉、성대마비、신공능쇠갈、위배공장애발생솔급병사솔적차이역무통계학의의(균P＞0.05).결론 흉복강경식관차전절제술치료식관암재기술상시안전가행적,재감소술중출혈량、강저술후심폐계통병발증화축단술후주원시간상구유우세.
Objective To evaluate the safety and efficacy of thoracolaparoscopic sultotal esophagectomy in the treatment of esophageal cancer.Methods Clinical data of 98 patients with esophageal cancer who underwent thoracolaparoscopic subtotal esophagectomy from March 2009 to October 2011 were retrospectively analyzed.One hundred and five patients were served as controls who underwent open three-field subtotal esophagectomy in the same period.Results There were significant differences between thoracolaparoscopic and open three-field subtotal esophagectomy in blood loss [(85.1±32.8) ml vs.(215.5±60.6) ml],length of stay [(12.7±3.5) d vs.(16.9±4.5) d]),pneumonia (4.1％ vs.12.4％,P＜O.05),atelectasis (3.1％ vs.10.5％,P＜0.05),pleural effusion (3.1％ vs.10.5％,P＜0.05),acute respiratory distress (1.0％ vs.7.6％,P＜0.05) and arrhvthmia (4.1％ vs.12.4％,P＜0.05).No significant differences were observed in the number of lymph node harvested,operative time,anastomotic leak,thoracic abscess,chyle chest,re-laparotony,re-thoracotomy,vocal cord paralysis,renal failure,gastric emptying,and mortality (all P＞0.05).Conclusion Thoracolaparoscopic subtotal esophagectomy is technically feasible and safe and is associated with less blood loss,less cadiopulmonary complication,and shorter hospital stay.
