胸腹腔镜联合与传统食管癌根治术疗效比较

Chest laparoscopy combined with esophageal carcinoma clinical and traditional radical surgery

目的比较胸腹腔镜联合行食管癌根治术与传统手术食管癌根治术的临床疗效。方法比较70例接受腔镜联合食管癌根治术与80例接受传统手术食管癌根治术患者的一般情况、病理学资料、术后并发症、复发或转移比例等方面的差异。结果腔镜联合组手术时间长于传统手术组，但术中出血量、术后胸腔引流液总量及术后吗啡用量少于传统手术组（P〈0．05或P〈0．01）。两组术后住院时间差异无统计学意义（P〉0．05）。腔镜联合组切除食管标本长度、肿瘤近端切缘长度长于传统手术组，但前者差异无统计学意义（P〉0．05），后者差异有统计学意义（P〈0．05）。两组淋巴结清扫数目及术后并发症和切口种植致局部复发发生率差异均无统计学意义（P〉0．05）。腔镜联合组术后反流性胃炎发生率7．1％，传统手术组45．0％，差异有统计学意义（P〈0．01）。两组术后同期复发转移率比较差异无统计学意义（P〉0．05）。结论胸腹腔镜联合食管癌根治术具有与传统开胸癌根治术相同的治疗效果，且创伤小，恢复快。

Objective To compare the clinical therapeutic effect of radical resection of esophageal carcinoma under combination of thoraeoseopy and laparoscopy （RECTL） with traditional radical resection of esophageal carcinoma （TREC）.Methods 80 patients receiving RECTL and 80 patients receiving TREC were chosen in our hospital. The general conditions during operation, pathologic data, postoperative complications and recurrence or metastasis rates were compared between twogroups. Results Compared with TREC group, RECTL group had longer operation time,less bleeding,less postoperative chest drainage liquid amount and less postoperative morphine administration（ P 〈 0.05 or P 〈 0.01 ）. The postoperative hospital stayswere not statistically different between the two groups （ P 〉 0.05 ）. The length of resected esophagus specimen and tumor near end cutting edge length in RECTL group are longer than that in TREC group, but with the former no statistically different（ P 〉0.05） and the latter statistically different （ P 〈 0.05 ）. There were no statistical differences about the number of dissected lymph nodes and the incidence of complications and local recurrence by cut plant between the two groups（ P 〉 0.05 ）. The inci-dence of postoperative reflux gastritis was 7.1% in RECTL group and 45% in TREC group, with significantly statistical difference （ P 〈 0.01 ）. The two groups had similar recurrence or metastasis rate（P 〉 0.05 ）. Conclusion Radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy, with small wound and early recovery, has the same effect as traditional operational resection of esophageal carcinoma.