中国全科医学
中國全科醫學
중국전과의학
Chinese General Practice
2015年
27期
3320-3323
,共4页
袁君%宗振峰%杨博%孔繁义%戴国光
袁君%宗振峰%楊博%孔繁義%戴國光
원군%종진봉%양박%공번의%대국광
食管肿瘤%胸腔镜检查%外科手术,微创性%治疗结果
食管腫瘤%胸腔鏡檢查%外科手術,微創性%治療結果
식관종류%흉강경검사%외과수술,미창성%치료결과
Esophageal neoplasms%Thoracoscopy%Surgical procedures,minimally invasive%Treatment outcome
目的:比较微创McKeown术与左后外切口路径手术治疗胸中下段食管癌的效果及安全性。方法选取2010年4月—2013年4月河北省沧州市中心医院收治的220例胸中下段食管癌患者,根据手术方法分为试验组100例,行微创McKeown术;对照组120例,行传统的左后外切口路径手术。对比两组患者围术期情况、术后并发症发生率及淋巴结转移情况。结果试验组患者术中出血量、术后住院时间较对照组减少( P<0.05);试验组患者淋巴结清扫数量较对照组增多(P<0.05)。试验组患者呼吸系统并发症、肺炎、肺不张、胸腔积液发生率较对照组降低(P <0.05);试验组患者胸胃坏死穿孔、胃排空障碍发生率较对照组升高( P<0.05)。试验组患者上纵隔及左、右侧喉返神经旁淋巴结转移率较对照组升高(P<0.05)。结论采用微创McKeown术治疗胸中下段食管癌,能减少术中出血量及术后住院时间,符合微创手术要求;但术后胸胃坏死穿孔、胃排空障碍发生率及上纵隔、左侧和右侧喉返神经旁淋巴结转移率较高。
目的:比較微創McKeown術與左後外切口路徑手術治療胸中下段食管癌的效果及安全性。方法選取2010年4月—2013年4月河北省滄州市中心醫院收治的220例胸中下段食管癌患者,根據手術方法分為試驗組100例,行微創McKeown術;對照組120例,行傳統的左後外切口路徑手術。對比兩組患者圍術期情況、術後併髮癥髮生率及淋巴結轉移情況。結果試驗組患者術中齣血量、術後住院時間較對照組減少( P<0.05);試驗組患者淋巴結清掃數量較對照組增多(P<0.05)。試驗組患者呼吸繫統併髮癥、肺炎、肺不張、胸腔積液髮生率較對照組降低(P <0.05);試驗組患者胸胃壞死穿孔、胃排空障礙髮生率較對照組升高( P<0.05)。試驗組患者上縱隔及左、右側喉返神經徬淋巴結轉移率較對照組升高(P<0.05)。結論採用微創McKeown術治療胸中下段食管癌,能減少術中齣血量及術後住院時間,符閤微創手術要求;但術後胸胃壞死穿孔、胃排空障礙髮生率及上縱隔、左側和右側喉返神經徬淋巴結轉移率較高。
목적:비교미창McKeown술여좌후외절구로경수술치료흉중하단식관암적효과급안전성。방법선취2010년4월—2013년4월하북성창주시중심의원수치적220례흉중하단식관암환자,근거수술방법분위시험조100례,행미창McKeown술;대조조120례,행전통적좌후외절구로경수술。대비량조환자위술기정황、술후병발증발생솔급림파결전이정황。결과시험조환자술중출혈량、술후주원시간교대조조감소( P<0.05);시험조환자림파결청소수량교대조조증다(P<0.05)。시험조환자호흡계통병발증、폐염、폐불장、흉강적액발생솔교대조조강저(P <0.05);시험조환자흉위배사천공、위배공장애발생솔교대조조승고( P<0.05)。시험조환자상종격급좌、우측후반신경방림파결전이솔교대조조승고(P<0.05)。결론채용미창McKeown술치료흉중하단식관암,능감소술중출혈량급술후주원시간,부합미창수술요구;단술후흉위배사천공、위배공장애발생솔급상종격、좌측화우측후반신경방림파결전이솔교고。
Objective To compare the curative effect of McKenzie minimally invasive esophagectomy and left rear outer incision surgery in the treatment of esophageal cancer in thoracic middle-lower segment. Methods Enrolled 220 patients with esophageal cancer in thoracic middle-lower segment who were admitted into Cangzhou Central Hospital from April 2010 to April 2013. According to surgical method,assigned 100 patients who received McKenzie minimally invasive esophagectomy into trial group and 120 patients who received conventional left rear outer incision surgery into control group. Comparison was made between the two groups in perioperative condition, incidence of complications after operation and condition of lymphatic metastasis. Results The trial group was lower(P<0. 05)than control group in the amount of bleeding and length of stay after operation;the trial group was higher(P<0. 05)than the control group in the number of lymph node cleaning. The trial group was lower(P<0. 05)than control group in the incidence rates of respiratory complication,pneumonia,pulmonary atelectasis and pleural effusion;the trial group was higher(P <0. 05)than the control group in the incidence rates of thoracic gastric necrosis and perforation and delayed gastric emptying. The trial group was higher(P<0. 05)than control group in the incidence rates of recurrent laryngeal nerve lymph node metastasis in superior mediastinum, on the left side and on the right side. Conclusion McKeown minimally invasive esophagetomy for the treatment of esophageal cancer in thoracic middle-lower segment can reduce the amount of bleeding and length of hospital stay after surgery,and it accords with the standard of minimally invasive surgery, while the incidence rates of thoracic gastric necrosis and perforation and delayed gastric emptying and the incidence rates of recurrent laryngeal nerve lymph node metastasis in superior mediastinum,on the left side and on the right side are high.