胸腹腔镜联合食管癌根治术临床疗效分析

Evaluation of the therapeutic effect of thoracoscopy combined with laparoscopy on the treatment of esophageal cancer

目的:探讨胸腹腔镜联合治疗食管癌的临床效果。方法:选择2014年1月至2016年1月在郑州大学第一附属医院住院行手术治疗的240例食管癌患者为观察组,另选同期在我院手术治疗的食管癌患者240例为对照组。观察组给予胸腔镜联合腹腔镜手术,对照组采用左侧开胸食管癌根治术,比较两组手术时间、术中出血量、术中清扫淋巴结数量、留置胸管时间、术后引流量、术后住院时间、并发症发生情况等。结果:观察组手术时间(190±16)min、术中出血量(140±24)m L、术中清扫淋巴结数量(13.0±1.8)枚、留置胸管时间(7.2±1.9)d、术后引流量(1 860±38)ml、术后住院时间(14.1±3.2)d、并发症发生率10.83%(26/240)分别与对照组(189±19)min、(282±31)m L、(7.0±1.6)枚、(10.4±2.3)d、(2 920±46)m L、(17.1±1.8)d、16.25%(39/240)比较,两组手术时间、并发症发生率差异无统计学意义(P>0.05),其余指标差异均具有统计学意义(P<0.05)。结论:胸腹腔镜联合微创手术治疗食管癌具有术中出血少、淋巴结清除彻底、术后恢复快等优势,值得临床推广。

Objective： To investigate the therapeutic effect of thoracoscopy combined with laparoscopy in the treatment of esophageal cancer. Methods： 160 cases of esophageal cancer admitted to the affiliated hospital of Zhengzhou University from Jan 2014 to Jan 2016 were selected as observation group, and another 160 cases of esophageal cancer in our hospital at the same were treated with thoracoscopy combined with time were chosen as control group. Patients in observation group laparoscopy, and patients in control group were treated with left incision thoracotomy esophageal cancer radical prostatectomy. The total operation time, total blood loss in surgery, total numbers of lymph node cleaned, the amount of thoracic cavity drainage, the length of postoperative hospital stay, and complication occurrence between the two groups were compared. Results： The operation time was （190 ± 16） min, the blood loss was （140 ± 24） mL, the number of lymph nodes dissected was （13.0 ± 1.8）, the chest tube drainage were （7.2 ± 1.9） days and （1 860 ± 38）mL, post-operation hospital stay was （14.1± 3.2） day, and the incidence rate of post-operative complications were 10.83% （26/240）in the observation group, whereas those in the control group were （189 ± 19） min, （282 ± 31） mL, （7.0±1.6）, （10.4 ± 2.3）, （2 920 ± 46）mL, （17.1 ± 1.8）d, and 16.25%（39/240）respectively. There were significant difference in all variables （P 〈 0.05） except the operation time and the incidence rate of post-operative complications （P 〉 0.05）.Conclusion： Laparoscopy combined with minimally invasive surgery in the treatment of esophageal recommended since it is associated with less bleeding, complete lymph node dissection, rapid cry. cancer is strongly postoperative recov- ery.