胸部小切口技术应用于食管中下段癌根治术中的临床分析

Clinical Study of Esophageal Cancer Radical Surgery with Minimally Invasive Incision

目的:探讨胸部小切口技术在食管中下段癌根治术中的临床应用,为其临床研究提供可参考依据。方法:随机选择共纳入50例入住我院确诊为食管中下段癌的患者作为研究对象,采用随机数字法平均分为观察组与对照组两组,根据患者病情给予相应处理后,观察组患者给予胸部小切口食管中下段癌根治切除术治疗措施;对照组患者给予传统开放性手术治疗措施。比较两组患者的手术时间、术中出血量、术后引流量、引流时间、住院时间及相关并发症等。结果:观察组患者的术中出血量(112.7±60.2)ml、术后引流量(174.4±121.3)ml、术后引流时间(112.4±60.2)min、住院时间(8.9±1.2)d均明显低于对照组患者术中出血量(290.4±120.5)ml、术后引流量(318.6±132.6)ml、术后引流时间(290.6±120.5)min、住院时间(12.9±4.2)d,两组间差异比较有统计学意义(P<0.05);而手术时间、5年生存率比较差异不明显(P>0.05)。术后吻合口瘘、乳糜胸、肺部感染是患者发生的主要并发症,其中观察组患者发生并发症2例,占8.0%,对照组患者发生并发症8例,占32.0%,两组间差异比较有统计学意义(P<0.05)。结论:胸部小切口技术在食管中下段癌根治术中不仅可以有效提高患者的生存率,且术中出血量及术后疗效均较传统治疗好。

Objective：To study the application of small thoracic incision for esophageal cancer radical surgery with comparabale to that of conventional incison. Methods：Randomly selected participants included 50 cases in our hospital diagnosed as middle segment esophagus cancer patients as the research object, the digital method using randomly divided into observation group and control group in two groups, according to patients condition accordingly after processing, the observation group patients give chest small incision middle segment esophagus cancer radical resection treatment measures;The control group with traditional surgery treatment. Comparison of two groups of patients with operation time, intraoperative blood loss, hospital stay and related complications. Results：Bleeding amount of observation group of patients with ml （112.7±60.2）, postoperative flow ml （174.4±121.3） and postoperative drainage time （112.4 ± 60.2） min, length of hospital stay （8.9 ± 1.2） were significantly lower than that of group control intraoperatie blood loss in patients with ml （290.4 ± 120.5）, postoperative flow ml （318.6±132.6） and postoperative drainage time （290.6 ± 120.5） min, length of hospital stay （12.9 ± 4.2） d, compare the difference between the two groups was statistically significant （P〈0.05）;While operating time, the 5-year survival rate less difference is not obvious （P〉0.05）.Postoperative anastomotic fistula, chylothorax, in patients with pulmonary infection was the main complication, including observation group of patients with complications occurred in 2 cases, accounting for 8.0%, group control patients, 8 cases of complications （32.0%）, and compare the difference between the two groups was statistically significant （P〈0.05）. Conclusion：The method of minimally invasive esophagectomy through a shorter incision on the left chest wall was feasible, which has less injury, less bleeding and the recovery is faster. But ithad unique advantages：shortoperation time.