胸腔镜食管癌根治术的临床效果及术后并发症观察

Observation of Clinical Effect and Postoperative Complications of Video-assisted Thoracoscopic Surgery in Patients with Esophageal Carcinoma

目的观察胸腔镜食管癌根治术的临床效果及术后并发症情况。方法选取2014年8月至2016年9月我院收治的92例食管癌患者,根据手术方式将患者分为观察组和对照组,每组46例,其中观察组行胸腔镜食管癌根治术,对照组行开放食管癌根治术。比较两组患者手术情况、肺功能的改变及术后并发症情况。结果比较两组患者的手术情况,观察组患者的手术时间明显长于对照组(P<0.05);观察组术中出血量、术后引流量、拔管时间及患者术后下床活动时间明显优于对照组(P<0.05);两组患者淋巴结清扫数量无明显差异(P>0.05)。观察组患者术后VC%、FEV1%明显优于对照组(P<0.05);两组患者术后FEV%、FVC%、MVV%比较无明显差异(P>0.05)。观察组术后共发生7例并发症,占15.22%,对照组患者术后共发生20例并发症,占43.48%;观察组术后并发症发生率明显低于对照组(P<0.05)。结论与传统开胸手术相比,胸腔镜食管癌根治术具有创伤小、康复时间短等优点,并且可降低术后并发症发生率,具有重要的临床意义。

Objective To observe the clinical effect and postoperative complications in patients with esophageal carcinoma treated by video-assisted thoracoseopic surgery. Methods From August 2014 to September 2016, 92 cases of esophageal carcinoma were treated in our hospital. The patients were divided into the observation group and the control group, with 46 patients in each group. The observation group was treated with video- assisted thoracoscopic surgery. And the control group was treated with open esophageetomy. The operation indexes, pulmonary function and postoperative complications were compared between the two groups. Results Op- eration time of the observation group was significantly longer than that of the control group （P 〈 0.05 ） ; The amount of intraoperative bleeding, postoperative drainage, extubation time and postoperative ambulation time of the observation group was significantly better than that of the control group （ P 〈 0.05 ）. There was no significant difference between the groups in the number of dissected lymph nodes （P 〉0.05）. The VC% and FEVI% of the observation group was significantly better than that of the control group （P 〈 0.05 ）. But there was no significant difference in FEV%, FVC% and MVV% between the two groups （ P 〉 0.05 ）. The postoperative complication rate of the observation group and the control group was 15.22% （7/46） and 43.48% （20/46） respectively; which showed obvious superiority of the observation group （P 〈 0.05）. Conclusion Comparing with traditional open chest surgery, it is recommended of the thoracoscopic radical resection for esophageal carcinoma patients for the advantages of less trauma, quicker recovery and less postoperative complication rate.