胸腔镜下食管癌切除术68例近期疗效观察

Short-term effect of 68 cases of esophageal cancer resection under the thoracoscope

目的总结胸腔镜下食管癌根治术的临床经验,评价其近期疗效。方法回顾性分析2011年9月至2013年12月行胸腔镜食管癌根治术68例患者的临床资料,其中男39例,女29例;年龄52.0～74.5岁,平均（62.0±2.5）岁。病灶位于上段10例,中段37例,下段21例。术前均行胃镜检查获取病理,68例为鳞状细胞癌。术前行胸部及上腹部增强CT及上消化道钡餐检查判断肿瘤浸润程度及与周围组织器官的关系,淋巴结转移情况,估计肿瘤切除可能性。结果本研究患者无围术期死亡,中转开胸2例。胸腔镜手术组平均淋巴结清扫个数（12.5±3.4）枚/例,胸部手术失血量（160.5±21.5）ml,术后胸管拔管时间（3.7±1.8）d,肺部并发症发生率为6.4%,总体住院时间（12.2±3.4）d。结论胸腔镜下食管癌切除术具有淋巴清扫彻底,胸部创伤小,总体并发症少,术后恢复快等优点,近期疗效满意。

Objective To summarize the clinical experience of the esophageal cancer radical resection under the thoraco- scope, and evaluate its recent curative effect. Methods The clinical data of 68 cases of esophageal cancer radical with thoraco- scope from September 2011 to December 2011 were retrospectively analyzed, 39 male and 29 female. The age range was 52.0 - 74.5 years old and the average age was （62. 0±2. 5）. Lesions located in the upper segment of the 10 cases, in the middle seg- ment of 37 cases, in the lower segment of 21 cases. Preoperative gastroscopy in pathology, 68 cases of squamous cell carcinoma. Preoperative, inspected on the chest and abdomen judging enhanced CT and barium meal examination of upper gastrointestinal tract tumor, the infihration degree and the relationship with the surrounding tissues and organ was judged, lymph node metastasis was judged and the tumor resection was estimated. Results There was no peroperative death in this group, 2 cases transit thoracotomy. The lymph nodes in thoracoseope surgery group average （12. 5 ± 3.4）per case, blood loss during surgery average （ 160. 5± 21.5 ） ml, the extubation time after operation was average （3.7 ± 3.7 ） days, the rate of plmonary complications was 6.4%. The overall length of hospital stay was （ 12.2 ± 3.4） days. Conclusion Esophagus cancer resection under the thoraco- scope is of advantage of lymph node cleaning thoroughly, less chest trauma, less complications, fast postoperative recovery, the short-term effects is satisfactory.