电视胸腔镜下行食管癌手术胸部淋巴结清扫的临床应用

Clinical application of video-assisted thoracoscopic esophageal cancer operation for thoracic lymph node dissection

目的探讨电视胸腔镜下行食管癌手术胸部淋巴结清扫的临床效果。方法 60例食管癌患者,依据患者入院顺序分为乙组(35例)和甲组(25例)。甲组患者通过电视胸腔镜下行食管癌手术进行治疗,而乙组患者通过常规开胸手术进行治疗,对比两组患者的临床及淋巴结清扫情况。结果甲组患者的术中失血量为(121.25±15.47)ml,乙组为(280.41±20.58)ml,对比差异具有统计学意义(P<0.05)。甲组患者术后的引流量为(280.17±34.45)ml,乙组为(352.47±46.84)ml,对比差异具有统计学意义(P<0.05)。甲组患者的住院时间为(9.51±1.34)d,乙组为(15.38±2.46)d,对比差异具有统计学意义(P<0.05)。甲组患者的治疗费用为(44521.25±332.47)元,乙组为(92046.28±517.57)元,对比差异具有统计学意义(P<0.05)。甲组患者气管旁、食管旁、支气管旁、下肺静脉旁以及隆突旁等部位的淋巴结清扫情况优于乙组患者(P<0.05)。结论电视胸腔镜下行食管癌手术胸部淋巴结清扫的临床应用效果很好,有效减少患者的术中出血量和术后引流量,并缩短患者的住院时间和降低治疗费用,且淋巴结清扫情况很好,值得推广。

Objective To investigate clinical effect by video-assisted thoracoscopic esophageal cancer operation for thoracic lymph node dissection. Methods A total of 60 patients with esophageal cancer were divided by their admission order into group B（35 cases） and group A（25 cases）. Group A received video-assisted thoracoscopic esophageal cancer operation for treatment, and group B received conventional thoracotomy for treatment. Comparison was made on clinical status and lymph node dissection condition between the two groups. Results Group A had intraoperative bleeding volume as（121.25±15.47） ml, which was（280.41±20.58） ml in group B, and their difference had statistical significance（P〈0.05）. Group A had postoperative drainage volume as（280.17±34.45） ml, which was（352.47±46.84） ml in group B, and the difference had statistical significance（P〈0.05）. Group A had hospital stay time as（9.51±1.34） d, which was（15.38±2.46） d in group B, and their difference had statistical significance（P〈0.05）. Group A had treatment cost as（44521.25±332.47） yuan, which was（92046.28±517.57） yuan in group B, and their difference had statistical significance（P〈0.05）. Group A had all better lymph node dissection condition in paratracheal lymph node, paraesophageal lymph node, peribronchial lymph node, inferior pulmonary vein lymph node and promontory lymph node than group B（P〈0.05）. Conclusion Video-assisted thoracoscopic esophageal cancer operation for thoracic lymph node dissection shows excellent effect in clinical application. This method can effectively reduce intraoperative bleeding volume and postoperative drainage volume, shorten hospital stay time and lower treatment cost, along with excellent lymph node dissection condition. It is worth promoting.