中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2013年
6期
339-341,361
,共4页
李京沛%谭黎杰%王群%汪灏%冯明祥%范虹%徐松涛%蒋伟%钱成
李京沛%譚黎傑%王群%汪灝%馮明祥%範虹%徐鬆濤%蔣偉%錢成
리경패%담려걸%왕군%왕호%풍명상%범홍%서송도%장위%전성
食管肿瘤%胸外科手术,电视辅助%微创食管切除术%总体生存率
食管腫瘤%胸外科手術,電視輔助%微創食管切除術%總體生存率
식관종류%흉외과수술,전시보조%미창식관절제술%총체생존솔
Esophageal carcinoma%Thoracic surgery,video assitant%Minimally invasive esophagectomy%Overall survival
目的 比较胸腔镜和开胸三切口食管癌根治术的围手术期并发症及中期疗效.方法 回顾性分析2005年1月至2012年6月间复旦大学附属中山医院胸外科收治827例接受三切口食管癌根治术患者的临床资料,其中胸腔镜482例和常规开胸345例.比较两组的围手术期相关指标及中期生存情况.结果 与开胸组相比,胸腔镜手术组平均淋巴结清扫个数更多[(28.3±5.1)个对(27.4±5.6)个,P=0.017],术后住院时间短[(14.6±5.6)天对(16.9±9.3)天,P=0.000],再入ICU率低(5.6％对10.1％,P=0.014),围手术期病死率低(1.0％对3.2％,P=0.027),围手术期总体并发症少(37.6％对44.9％,P=0.033),呼吸系统并发症少(9.3％对13.9％,P=0.040).胸腔镜组术后1年、2年、3年生存率略优于开胸组,但组间差异均无统计学意义.结论 胸腔镜与开胸手术与三切口食管癌根治术相比,围手术期疗效优势比较明显,中期疗效的优势尚有待于进一步验证.
目的 比較胸腔鏡和開胸三切口食管癌根治術的圍手術期併髮癥及中期療效.方法 迴顧性分析2005年1月至2012年6月間複旦大學附屬中山醫院胸外科收治827例接受三切口食管癌根治術患者的臨床資料,其中胸腔鏡482例和常規開胸345例.比較兩組的圍手術期相關指標及中期生存情況.結果 與開胸組相比,胸腔鏡手術組平均淋巴結清掃箇數更多[(28.3±5.1)箇對(27.4±5.6)箇,P=0.017],術後住院時間短[(14.6±5.6)天對(16.9±9.3)天,P=0.000],再入ICU率低(5.6％對10.1％,P=0.014),圍手術期病死率低(1.0％對3.2％,P=0.027),圍手術期總體併髮癥少(37.6％對44.9％,P=0.033),呼吸繫統併髮癥少(9.3％對13.9％,P=0.040).胸腔鏡組術後1年、2年、3年生存率略優于開胸組,但組間差異均無統計學意義.結論 胸腔鏡與開胸手術與三切口食管癌根治術相比,圍手術期療效優勢比較明顯,中期療效的優勢尚有待于進一步驗證.
목적 비교흉강경화개흉삼절구식관암근치술적위수술기병발증급중기료효.방법 회고성분석2005년1월지2012년6월간복단대학부속중산의원흉외과수치827례접수삼절구식관암근치술환자적림상자료,기중흉강경482례화상규개흉345례.비교량조적위수술기상관지표급중기생존정황.결과 여개흉조상비,흉강경수술조평균림파결청소개수경다[(28.3±5.1)개대(27.4±5.6)개,P=0.017],술후주원시간단[(14.6±5.6)천대(16.9±9.3)천,P=0.000],재입ICU솔저(5.6％대10.1％,P=0.014),위수술기병사솔저(1.0％대3.2％,P=0.027),위수술기총체병발증소(37.6％대44.9％,P=0.033),호흡계통병발증소(9.3％대13.9％,P=0.040).흉강경조술후1년、2년、3년생존솔략우우개흉조,단조간차이균무통계학의의.결론 흉강경여개흉수술여삼절구식관암근치술상비,위수술기료효우세비교명현,중기료효적우세상유대우진일보험증.
Objective To determine if thoracoscopic minimally invasive esophagectomy enables greater perioperative and medium-term clinic outcome than open thoracic esophagectomy for esophageal carcinoma.Methods From January 2005 to June 2012,482 patients with esophageal carcinoma received thoracoscopic minimally invasive esophagectomy (MIE group),while 322 patients underwent conventional open thoracic esophagectomy (OE group).Perioperative and medium-term clinic outcome were compared between the two groups.Results The clinical data were comparable,and no significant difference was found in demographics between the two groups.Compared with OE group,MIE group has more retrieved lymph nodes(28.3 ±5.1 vs.27.4 ±5.6,P =0.017),less postoperative hospital stay [(14.6 ±5.6)days vs.(16.9 ±9.3) days,P =0.000],less rate of readmission to ICU (5.6％ vs.10.1％,P =0.014),less total perioperative complications(37.6％ vs.44.9％,P =0.033) and less pulmonary complication(9.3％ vs.13.9％,P =0.040).Lower mortality rate was also found in MIE group than OE group(1.0％ vs.3.2％,P =0.027).No statistical significance in pathologic staging was found between the OE and MIE groups.Generally,no statistically significant difference was found between the OE and MIE groups for survival within each time interval (1,2,and 3 years),although the difference favored the MIE group.Conclusion Thoracoscopic minimally invasive esophagectomy has some advantages than open procedure in the aspect of surgical safety,while the mediumterm outcome benefits fail to reach statistic advantage.
