微创与开放手术治疗食管癌的临床对照研究

Clinical Comparative Research on Minimal Invasive and Open Operation in Treatment of Esophageal Cancer

目的探讨微创术式与开放术式治疗食管癌的疗效、应用价值、可行性与安全性。方法纳入2013年1月—2015年12月在该院外科治疗的180例食管癌患者。根据手术方式不同分为腹腔镜手术组(n=65)与开放式手术组(n=115),收集并比较患者术后住院时间、胸管留置时间、淋巴结清扫个数、肿瘤分期、手术时间、术中出血量、呼吸系统并发症与外科手术并发症等资料并对患者进行术后随访。结果两组患者胸管留置时间比较差异有统计学意义(P=0.001),术后住院时间、淋巴结清扫个数与肿瘤分期比较差异无统计学意义(P>0.05);开放手术组手术时间显著低于腹腔镜手术组(252 min vs 295 min,P=0.002),腹腔镜组术中出血量显著小于开放手术组(120 m L vs 180 m L,P<0.05)。两组患者呼吸系统并发症、外科手术并发症、发生率差异无统计学意义(P>0.05)。结论微创食管癌手术近期疗效好、恢复快、出血少,值得临床推广。

Objective To discuss the curative effect, application value, feasibility and security of minimal invasive operation method and open operation method in treatment of esophageal cancer. Methods 180 cases of patients with esophageal cancer treated in the department of surgery of our hospital from January 2013 to December 2015 were selected and divided into the laparoscopic operation group（n=65） and open operation group（n=115）, the data such as postoperative length of stay, indwelling time of thoracic duct, number of lymph node dissection, tumor staging, operation time, intraoperative blood loss,respiratory complications and surgical complications were collected and compared, and the patients were followed up after operation. Results The difference in the indwelling time of thoracic duct between the two groups was statistically significant by comparison P =0.001, the differences in the postoperative length of stay, number of lymph node dissection and tumor staging were not statistically significant P〉0.05, the operation time in the open operation time was obviously lower than that in the laparoscopic operation group,（252 min vs 295 min, P=0.002）, the intraoperative blood loss in the laparoscopic operation group was obviously less than that in the open operation group（120 m L vs 180 m L, all P〈0.05）, the differences in the respiratory complications,surgical complications and incidence between the two groups were not statistically significant（all P〈0.05）. Conclusion Minimal invasive operation in treatment of esophageal cancer has a good short-term curative effect,quick rapid and less hemorrhage, which is worth clinical promotion.