CAJ | 학술논문

目的评价胸腹腔镜联合食管癌切除荷包钳法右胸内吻合的安全性、可行性和近期疗效.方法回顾性分析2011年10月至2014年3月接受微创食管癌手术的357例患者资料,其中219例患者施行微创lvor-Lewis术(minimally invasive Ivor-Lewis esophagectomy,MIILE),138例施行微创McKeown术(Minimally invasive McKeown esophagectomy,MIME).比较分析两组患者的临床和围手术期相关资料、术后并发症和肿瘤复发情况.结果两组在性别、年龄、肿瘤部位和术后TNM分期方面无明显差异.手术时间、术中出血、术后住院时间、术后引流时间和住院费用方面施行MIILE的患者与施行MIME的患者无明显差异(P＞0.05).两组患者术后总并发症发生率亦无明显差异(24.7％对30.4％,P＞ 0.05);但吻合口瘘、喉返神经损伤、吻合口狭窄方面的发生率低(P＜0.05).结论微创Ivor-Lewis术治疗胸中下段食管癌是安全可行的,相对于微创McKeown术有一定优势,近期结果满意.
목적 평개흉복강경연합식관암절제하포겸법우흉내문합적안전성、가행성화근기료효.방법 회고성분석2011년10월지2014년3월접수미창식관암수술적357례환자자료,기중219례환자시행미창lvor-Lewis술(minimally invasive Ivor-Lewis esophagectomy,MIILE),138례시행미창McKeown술(Minimally invasive McKeown esophagectomy,MIME).비교분석량조환자적림상화위수술기상관자료、술후병발증화종류복발정황.결과 량조재성별、년령、종류부위화술후TNM분기방면무명현차이.수술시간、술중출혈、술후주원시간、술후인류시간화주원비용방면시행MIILE적환자여시행MIME적환자무명현차이(P＞0.05).량조환자술후총병발증발생솔역무명현차이(24.7％대30.4％,P＞ 0.05);단문합구루、후반신경손상、문합구협착방면적발생솔저(P＜0.05).결론 미창Ivor-Lewis술치료흉중하단식관암시안전가행적,상대우미창McKeown술유일정우세,근기결과만의.
Objective To investigate the feasibility,safety and curative effect of combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity.Methods We retrospectively evaluated 357patients with esophageal carcinoma who received minimally invasive esophagectomy(MIE) in our center between October 2011 and March 2014.Of those 357 patients,219 underwent MIILE and 138 underwent MIME.The clinicopathologic factors,operational factors,postoperative complications and postoperative recurrence were compared.Results The 2 groups were similar in terms of age,sex,American Society of Anesthesiologists grade,tumor location,preoperative staging.The MILLE approach was associated with no significant decrease in surgical blood loss.Duration of operation,chest tube duration,hospitalization expenses and postoperative stay relative to the MIME approach(P ＞ 0.05).There was no significant difference between the 2 groups in postoperative complications(P ＞0.05).The MIILE approach was associated with significantly fewer anastomotic fistula,RLN injury,anastomotic stensis than the MIME approach(P ＜0.05).Conclusion Our MIILEtechnique can be safely and effectively performed for intrathoracic anastomosis during esophageal surgeries with favorable early outcomes.