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
950-953
,共4页
侯予龙%赵建强%郭伟%臧豹%唐德荣
侯予龍%趙建彊%郭偉%臧豹%唐德榮
후여룡%조건강%곽위%장표%당덕영
食管肿瘤%胸腔镜手术%食管切除术%俯卧位%左侧卧位
食管腫瘤%胸腔鏡手術%食管切除術%俯臥位%左側臥位
식관종류%흉강경수술%식관절제술%부와위%좌측와위
Esophageal neoplasms%Thoracolaparoscopic esophagectomy%Esophagectomy%Prone position
目的 比较俯卧位和左侧卧位两种胸腔镜治疗食管癌的临床效果.方法 回顾性分析2008年9月至2010年9月在南京医科大学附属淮安第一医院胸心外科接受胸腔镜食管切除术、临床分期在T3N1Mo以下的82例食管癌患者的临床资料,采用俯卧位和左侧卧位各41例.结果 俯卧位组和左侧卧位组肿瘤位于食管上段分别为2例和3例;位于食管中段分别为12例和9例;位于食管下段分别为27例和29例.俯卧位组和左侧卧位组手术平均用时分别为230 (170～310) min和280(190～380)min,差异有统计学意义(P=0.04);术中平均出血量分别为275(100～320) ml和360(120～670) ml,差异无统计学意义(P=0.09)；平均清扫淋巴结数目分别为8.4(4～23)枚/例和6.9(6～21)枚/例,差异有统计学意义(P=0.03).全组患者无围手术期死亡.两组分别有6例(14.6％)和8例(17.1％)患者出现术后并发症,差异无统计学意义(P=0.44).俯卧位组术后平均随访15.7(2～28)个月,19例死亡;左侧卧位组术后平均随访16.3(3～31)个月,21例死亡,差异无统计学意义(P=0.14).结论 临床分期在T3N1M0以下的食管癌患者行胸腔镜手术治疗,采取俯卧位与左侧卧位手术疗效相同,但俯卧位手术时间短并有利于淋巴结清扫.
目的 比較俯臥位和左側臥位兩種胸腔鏡治療食管癌的臨床效果.方法 迴顧性分析2008年9月至2010年9月在南京醫科大學附屬淮安第一醫院胸心外科接受胸腔鏡食管切除術、臨床分期在T3N1Mo以下的82例食管癌患者的臨床資料,採用俯臥位和左側臥位各41例.結果 俯臥位組和左側臥位組腫瘤位于食管上段分彆為2例和3例;位于食管中段分彆為12例和9例;位于食管下段分彆為27例和29例.俯臥位組和左側臥位組手術平均用時分彆為230 (170～310) min和280(190～380)min,差異有統計學意義(P=0.04);術中平均齣血量分彆為275(100～320) ml和360(120～670) ml,差異無統計學意義(P=0.09)；平均清掃淋巴結數目分彆為8.4(4～23)枚/例和6.9(6～21)枚/例,差異有統計學意義(P=0.03).全組患者無圍手術期死亡.兩組分彆有6例(14.6％)和8例(17.1％)患者齣現術後併髮癥,差異無統計學意義(P=0.44).俯臥位組術後平均隨訪15.7(2～28)箇月,19例死亡;左側臥位組術後平均隨訪16.3(3～31)箇月,21例死亡,差異無統計學意義(P=0.14).結論 臨床分期在T3N1M0以下的食管癌患者行胸腔鏡手術治療,採取俯臥位與左側臥位手術療效相同,但俯臥位手術時間短併有利于淋巴結清掃.
목적 비교부와위화좌측와위량충흉강경치료식관암적림상효과.방법 회고성분석2008년9월지2010년9월재남경의과대학부속회안제일의원흉심외과접수흉강경식관절제술、림상분기재T3N1Mo이하적82례식관암환자적림상자료,채용부와위화좌측와위각41례.결과 부와위조화좌측와위조종류위우식관상단분별위2례화3례;위우식관중단분별위12례화9례;위우식관하단분별위27례화29례.부와위조화좌측와위조수술평균용시분별위230 (170～310) min화280(190～380)min,차이유통계학의의(P=0.04);술중평균출혈량분별위275(100～320) ml화360(120～670) ml,차이무통계학의의(P=0.09)；평균청소림파결수목분별위8.4(4～23)매/례화6.9(6～21)매/례,차이유통계학의의(P=0.03).전조환자무위수술기사망.량조분별유6례(14.6％)화8례(17.1％)환자출현술후병발증,차이무통계학의의(P=0.44).부와위조술후평균수방15.7(2～28)개월,19례사망;좌측와위조술후평균수방16.3(3～31)개월,21례사망,차이무통계학의의(P=0.14).결론 림상분기재T3N1M0이하적식관암환자행흉강경수술치료,채취부와위여좌측와위수술료효상동,단부와위수술시간단병유리우림파결청소.
Objective To compare the short-term outcomes in patients with esophageal cancer after subtotal esophagectomy via thoracoscopy in prone position and in left lateral position.Methods Between September 2008 and September 2010,thoracolaparoscopic esophagectomy (TLE) with thoracoscopic mobilization of the esophagus and mediastinal esophagectomy was performed in 41 patients in prone position (group A) and other 41 patients (group B) performed bv the same surgeon in left lateral position.Results Preoperatively,the endoscopic location of the tumor was in the upper third in 5 cases(2 vs.3),the middle third in 21 cases(12 vs.9),and the lower third in 56 cases(27 vs.29).The median operative time was 230 (range 170-310) min in group A and 280(range 190-380) min in group B (P=0.04).The median intraoperative blood loss was 275 (range 100-320) ml in group A and 360 (range 120-670) ml in group B (P=0.09).The median number of lymph nodes dissected was 8.4 (range 4-23) in group A and 6.9 (range 6-21 ) in group B (P=0.03).The postoperative complications totaled 6(14.6％) in group A and 8(17.1％) in group B(P=0.44).After a median follow-up period of 15.7(range 2-28) months for group A and 16.3(range 3-31 ) months for group B,19 patients in group A died and 21 patients in group B.Conclusions For esophageal cancer under T3N1M0,surgical outcomes are similar between prone thoracoscopic esophageal mobilization and left lateral position.Prone position may be associated with better lymph node dissection.
