胸腔镜下食管癌切除术25例临床病例分析

Clinical Analysis of 25 Cases of Esophageal Cancer Resection under Thoracoscope

目的总结胸腔镜下食管癌根治术的临床经验及体会,评价其近期疗效.方法回顾性分析昆明医科大学第一附属医院胸外科2013年8月至2015年3月间行胸腔镜食管癌根治术25例患者的临床资料.结果围手术期无死亡病例,其中有3例术中中转开胸.与开胸手术相比,胸腔镜组淋巴结清扫个数平均为(13.8±3.4)/例:(11.1±2.6)/例;胸部手术失血量更少(160.5±24)ml:(290.5±36.5)ml;术后胸管拔管时间更短(3.9±1.5)d:(4.9±2.4)d;肺部并发症更少(7.3%):(15.6%);总体住院时间更短(12.3±3.5)d:(15.4±5.6)d;但胸部手术时间更长(125±43.5)min/例:(60.5±30.6)min/例.结论胸腔镜下食管癌根治术作为外科微创一种新型的技术,其对外科医生手术技术及器械要求较高,但多方面的优点弥补了开胸手术的不足,只要硬件条件及临床手术条件允许下,应积极推广应用.胸腔镜下食管癌切除术与传统开胸手术相比,具有淋巴清扫彻底、创伤小、出血少、并发症少、术后恢复快等优点,治疗效果令人满意.

Objective To summarize the clinical experience of the division under the thoracoscope esophagus cancer radical and appreciate, evaluate its recent curative effect.Methods Our department were retrospectively analyzed in August 2013 to March 2015 between thoracoscope the clinical data of 25 cases with esophageal cancer radical.Results This group of patients with no perioperative death, transit thoracotomy in 3patients.Thoracoscope surgery group the average number of lymph node cleaning more（13.8 ±3.4） /cases：（11.1± 11.1） /cases;Chest surgery less blood loss（160.5±24） ml： ml（290.5±36.5）; Shorter postoperative chest tube drawing tube（3.9±1.5）, d（4.9±2.4） d; Pulmonary complications（7.3%） less（15.6%）;Overall a shorter hospital stay（12.3±3.5） d：（15.4±5.6） d;But the chest surgery longer（125±43.5）min/example： minf/cases（60.5-30.6）.Conclusion Cavity mirror as a new type of esophageal cancer radical surgery minimally invasive techniques,due to its for a surgeon, equipment and technical requirement is high, in the clinical development process of twists and turns, its various advantages make up for the deficiency of the esophageal cancer radical open completely,in conditions allow clinical surgery should be widely applied. Compared with traditional three incisions under thoracoscope esophagus cancer resection, with lymph node cleaning thoroughly, small trauma,less bleeding,fewer complications, quick recovery, treatment effect is satisfactory.