电视辅助胸腔镜手术与传统开胸手术治疗食管胸段癌对照研究

A control study of video -assisted thoracoscopic surgery （VATS）and conventional thoracotomy in treatment of thoracic esophagus cancer

目的：比较电视辅助胸腔镜手术与传统开胸手术治疗食管胸段癌的效果，为临床提供参考。方法选取自2012年1月至2015年1月经山西省人民医院诊治的90例食管胸段癌患者作为研究对象，依据随机数字表法分为观察组（应用电视辅助胸腔镜治疗）以及对照组（应用传统开胸手术治疗），比较两组术中出血量、胸腔引流量、住院恢复时间、并发症状况等指标的差异。结果观察组手术时间（267．6±76.5）min，短于对照组的（324．4±87．6）min，术中出血量（235．3±79．5）mL、胸腔引流量（327．5±95.2）mL，显著少于对照组的（398．2±98．3）mL 和（752．6±156．4）mL，术后住院时间（12．2±3．2）d，短于对照组（15．8±4.4）d，差异具有统计学意义（t ＝3．276、8．644、15．575、4．439，均 P ＜0．05）。经随访，两组复发及转移率、病死率及总生存率间比较，差异均无统计学意义（χ^2＝0．123、0．212、0．212，均 P ＞0．05）。观察组并发症发生率低于对照组，差异有统计学意义（χ^2＝4．865，P ＜0．05）。结论在食管胸段癌的治疗中，电视辅助胸腔镜手术与传统开胸手术均具有良好的效果，且电视辅助胸腔镜手术损伤小，并发症少。

Objective To investigate the effect of video -assisted thoracoscopic surgery （VATS）and conventional thoracotomy in treatment of thoracic esophagus cancer,to provide the reference for clinical.Methods 90 cases of thoracic esophageal cancer in our hospital from January 2012 to January 2015 were chosen as the research subjects.They were randomly divided into observation group（application of VATS treatment）and the control group （application of traditional open chest surgery）.The quantity difference,chest drainage,hospitalization time,complica-tions,recovery conditions and other indicators of bleeding were compared in the two groups.Results The operation time of the observation group[（267.6 ±76.5）min]was shorter than that of the control group[（324.4 ±87.6）min]. The amount of intraoperative bleeding[（235.3 ±79.5）mL],drainage volume[（327.5 ±95.2）mL]of the observation group were less than the control group[（398.2 ±98.3）mL and （752.6 ±156.4）mL].Postoperative hospitalization time[（12.2 ±3.2）d]of the observation group was shorter than the control group[（15.8 ±4.4）d].The differences were statistically significant （t =3.276,8.644,15.575,4.439,all P 〈0.05）.There were no significant differences between two groups in recurrence and metastasis rate,mortality rate and total survival rate （χ2 =0.123,0.212, 0.212,all P 〉0.05）.The complication rate of the observation group was lower than that of the control group,the difference was statistically significant （χ2 =4.865,P 〈0.05）.Conclusion In the treatment of thoracic esophageal carcinoma,VATS and conventional thoracotomy surgery has good effect,and VATS has small injury,less complication.