胸腔镜腹腔镜联合食道癌手术与开放手术治疗效果比较

Laparoscopic combined thoracoscope esophagus cancer surgery compared with open surgery treatment effect

目的探讨胸腹腔镜联合食道癌手术的临床疗效和安全性,讨论与开放手术临床疗效的差异。方法回顾性分析2004年8月～2014年8月我院的58例食管癌患者,其中应用胸腔镜腹腔镜联合食道癌手术的31例,应用传统开放手术的27例,比较两组患者的手术情况,如手术时间、术中出血量、术中淋巴结清扫数、术后引流时间、住院时间和术后疼痛时间,以及术后并发症发生情况。结果胸腔镜腹腔镜联合手术组的患者手术时间和术后引流时间较开放手术组短（P〈0.05）;术中出血量较开放手术组少（P〈0.05）;术后的疼痛评分较开放手术组低（P〈0.05）;两组手术方式中淋巴结的清理数与住院时间无统计学差异（P〉0.05）;术后胸腔镜腹腔镜手术组的并发症发生率显著低于开放手术组（P〈0.05）。结论胸腔镜腹腔镜联合手术治疗食道癌较传统开放手术治疗方法具有创伤小、时间短、并发症少等优点,可提高患者的生活质量,值得进一步研究和临床推广应用。

Objective To explore the clinical curative effect of surgery and security for combined laparoscopicthoracoscopic esophagectomy operation, discuss the difference between clinical surgery and combined laparoscopicthoracoscopic esophagectomy operation. Methods 58 cases of esophageal cancer patients were analyzed in August 2004- August 2014, in which 31 cases of laparoscopic applications combined thoracoscopic esophageal cancer surgery, the application of traditional open surgery, 27 cases were compared in patients with surgical conditions such as operative time, blood loss, number of lymph node dissection surgery, postoperative drainage time, hospital stay and postoperative pain time, and postoperative complications were observed. Results The laparoscopic-thoracoscopic esophagectomy operation with shorter operation was better than open surgery group（P〈0.05）, postoperative pain score was lower than those of open surgery group. Combined laparoscopic-thoracoscopic esophagectomy operation can help patients to improve the living quality, and it should be deserved for the further research and clinical application. Conclusion Thoracoscopic treatment of esophageal laparoscopic surgery with less trauma, time is short, fewer complications than traditional open surgery method, can improve the quality of life of patients, worthy of further research and clinical application.