CAJ | 학술논문

目的分析电视胸腔镜食管癌切除术中及术后并发症发生的特点.方法回顾自2009年1月至2012年12月366例接受电视胸腔镜食管癌切除术的胸段食管癌患者临床资料,分析围术期情况.男278例,女88例;年龄(60.9±8.3)岁.病变长度(4.6±2.0)cm.行胸腔镜加开腹手术269例,胸腹腔镜联合手术97例.结果全组手术时间(304.3 ±66.2)min;术中失血量(299.0±197.5) ml;清扫淋巴结(19.1±5.9)个.31例(8.5％)中转开放手术.术后死亡9例(2.5％).术中并发症19例(5.2％),术后并发症162例(44.3％).结论本组电视胸腔镜食管癌切除术中最常见并发症是出血(3.6％),术后最常见的并发症是颈部吻合口瘘(16.7％).患者术后死亡原因主要为吻合口-胸腔瘘及吻合口-气管瘘.
목적 분석전시흉강경식관암절제술중급술후병발증발생적특점.방법 회고자2009년1월지2012년12월366례접수전시흉강경식관암절제술적흉단식관암환자림상자료,분석위술기정황.남278례,녀88례;년령(60.9±8.3)세.병변장도(4.6±2.0)cm.행흉강경가개복수술269례,흉복강경연합수술97례.결과 전조수술시간(304.3 ±66.2)min;술중실혈량(299.0±197.5) ml;청소림파결(19.1±5.9)개.31례(8.5％)중전개방수술.술후사망9례(2.5％).술중병발증19례(5.2％),술후병발증162례(44.3％).결론 본조전시흉강경식관암절제술중최상견병발증시출혈(3.6％),술후최상견적병발증시경부문합구루(16.7％).환자술후사망원인주요위문합구-흉강루급문합구-기관루.
Objective As one of the common approaches in minimally invasive esophagectomy (MIE),thoracoscopic esophagectomy (TE),was developed to reduce the trauma resulting from the surgical treatment of esophageal cancer.The aim of this study is to retrospectively analyze the clinicopathologic factors and perioperitive complieations of 366 patients underwent TE,evaluate the characteristic of complications after TE by reviewing the records.Methods From Jan 2009 to Dec 2012,366consecutive TE for esophageal cancer were performed in our department.The demographic characteristics,as well as the intraoperative and postoperative variables were collected retrospectively and evaluated.Among these 366 cases,278 were male and 88 were female.The mean age was (60.9 ± 8.3) years,with (4.6 ± 2.0) cm for mean length of lesion.Totally,there were 269 cases of TE and 97 cases of thoracolaparoscopic esophagectomy (TLE) were performed.Results The total operative time was (304.3 ±66.2) min.The mean blood loss was (299.0 ± 197.5) ml,while 19.1 ±5.9 retrieved nodes were harvested.In these patients,31 cases (8.5％) need conversion to thoracotomy during operation.Nine postoperative deaths were observed,and the operative mortality was 2.5％ (9/366).Totally,the incidence of intraoperative complication was 5.2％(19/366),and the postoperative mobidity was 44.3％ (162/366).Conclusion The most common intraoperative complication of TE in this study is bleeding (with incidence of 3.6％,13/366),while the anastomotic leakage (16.7％,61/366) is the most common postoperative complication.Among our patients in this study,the major cause of postoperative death is anastomotic stoma-thoracic fistula and anastomotic stoma-tracheal fistula.