VATS食管癌根治术在食管鳞癌治疗中的疗效及安全性研究

Curative effects of video-assisted thoracoscopic esophagectomy on squamous cell esophageal cancer and its safety

目的探讨胸腔镜（VATS）食管癌根治术对食管鳞癌的治疗效果及安全性。方法回顾性分析2013年9月-2015年9月于我院进行食管癌根治术的食管鳞癌患者68例,按照手术方式不同分为观察组35例及对照组33例。观察组行VATS食管癌根治术,对照组行传统开胸食管癌根治术。对两组围手术期指标、淋巴结清扫数和并发症发生情况及患者术后生活质量进行对比分析。结果观察组术中出血量、术后胸腔积液引流量、胸腔引流管保留时间、下床活动时间及住院时间均少于对照组（P〈0.05）,而在手术时间及医疗费用方面,两组差异无统计学意义（P〉0.05）;两组胸部、腹部淋巴结及淋巴结清扫总数均无统计学差异（P〉0.05）。患者出院前进行生活质量评分对比,观察组在生理方面评分明显高于对照组（P〈0.05）,而在心理方面评分无统计学差异（P〉0.05）。结论与传统开胸手术相比,VATS食管癌根治术治疗食管鳞癌具有较好的疗效及安全性,对于患者生活质量的提高具有积极的意义,值得临床推广应用。

Objective To explore the curative effects and safety of video-assisted thoracosopic esophagectomy（VATS） in the treatment of squamous cell esophageal cancer.Methods 68 cases of squamous cell esophageal cancer undergoing esophagectomy between September 2013 and September 2015 were retrospectively analyzed and divided into observation group with 35 cases and control group with 33 cases according to the different methods of operation.The VATS esophagectomy was carried out in the observation group,and the traditional thoracotomy was given to the control group.Comparison and analysis were made in the perioperative indexes,lymph node clearance,complication incidence,and postoperative life quality between the two groups.Results The intraoperative blood loss,pleural effusion volume,drainage tube keeping time,ambulation time,and hospital stays in the observation group were significantly less than those in the control group（P〈0.05）,while there were no significant difference in the operation time and medical costs between the two groups（P〈0.05）.The differences in the number of thoracic and abdominal lymph nodes and the total number of lymph node clearance were not significant between the two groups（P〈0.05）.The scores of biological aspects in the observation group were higher than those in the control group（P〈0.05）,but the differences in the scores of the psychological aspects were not significant between the two groups（P〈0.05） before the discharge.Conclusion Compared with the traditional thoracotomy,VATS esophagectomy has better curative effects and safety,which has a positive significance in improving the patients＇ life quality and is worthy of clinical application.