刮吸解剖法和传统电刀法在乳腺癌、肺癌、食管癌手术中的比较研究

Comparison between curettage and aspiration dissection technique and traditional electric knife technique in the surgery for breast cancer,lung cancer,and esophageal cancer

目的比较刮吸解剖法和传统电刀法在乳腺癌、肺癌、食管癌手术中的应用情况。方法收集2014年10月至2016年6月南通市肿瘤医院收治的98例乳腺癌、肺癌、食管癌手术患者的临床资料。48例行刮吸解剖法手术,为刮吸解剖组,其中乳腺癌14例、肺癌16例、食管癌18例;50例行传统电刀法手术,为传统电刀组,其中乳腺癌16例、肺癌17例、食管癌17例。对两组的术中出血量、手术时间及淋巴结清扫数目进行比较。结果刮吸解剖组:乳腺癌术中出血量为(33.21±9.32)ml,手术时间为(65.71±6.75)min,淋巴结清扫数目为(12.14±2.32)个;肺癌术中出血量为(296.25±67.71)ml,手术时间为(104.38±13.02)min,淋巴结清扫数目为(19.63±3.30)个;食管癌术中出血量为(271.67±48.40)ml,手术时间为(166.39±15.40)min,淋巴结清扫数目为(19.78±2.02)个。传统电刀组:乳腺癌术中出血量为(51.25±10.72)ml,手术时间为(73.44±9.61)min,淋巴结清扫数目为(9.25±2.24)个;肺癌术中出血量为(397.65±72.40)ml,手术时间为(115.59±14.12)min,淋巴结清扫数目为(17.06±2.86)个;食管癌术中出血量为(336.47±71.40)ml,手术时间为(191.76±15.10)min,淋巴结清扫数目为(18.06±2.01)个。两组均无围手术期死亡病例,刮吸解剖组优于传统电刀组,在术中出血量、手术时间、淋巴结清扫数目方面两组比较,差异有统计学意义(均P<0.05)。结论刮吸解剖法用于乳腺癌、肺癌、食管癌手术安全,可减少术中出血,加快手术速度,提高手术质量。

Objective To compare ＂Curettage and Aspiration Dissection Technique＂ （CADT） with traditional electric knife technique in the treatment of thoracic tumor. Methods The clinical data of 98 patients underwent breast cancer, lung cancer, or esophageal cancer surgery in this hospital were analyzed retrospective- ly, and the patients were divided into the group of CADT （48 cases） and the group of traditional electric knife technique （50 eases）. The CADT group included breast cancer in 14 eases, lung cancer in 16 eases, and e- sophageal cancer in 18 eases. The traditional electric knife technique included breast cancer in 16 cases, lung cancer in 17 cases, and esophageal cancer in 17 cases. The difference between the two methods was compared in operative time, the volume of bleeding during operation, the amount of removed lymph nodes. Results The operation time, volume of intraoperative blood loss, the amount of removed lymph nodes dissected of breast cancer in CADT were （33. 21 ± 9. 32） ml, （65. 71 ± 6. 75） rain, and （ 12. 14 ± 2.32） , respectively. Lungcancer appeared （296. 25 ±67.71 ） ml, （ 104. 38 ± 13.02） min, and （ 19.63 ± 3.30 ）, respectively. Esopha- geal cancer showed （27 l. 67 ± 48.40 ） ml, （ 166. 39 ± 15.40 ） rain, and （ 19. 78 ± 2. 02 ）, respectively. The operation time, volume of intraoperative blood loss, the amount of removed lymph nodes dissected of breast cancer in traditional electric knife technique were （51.25 ± 10.72） ml, （73.44 ± 9.61 ） rain, and （9.25 ± 2. 24）, respectively. Lung cancer appeared （397.65 ±2. 40） ml, （ 115.59 ±14. 12） min, and （ 17. 06 ±2. 86） , respectively. Esophageal cancer showed （336.47 ±1.40） ml, （ 191.76 ±15.10） rain, and （ 18.06 ±2.01 ） , respectively. Both groups had no death cases in the perioperative period. The duration of operation, the volume of bleeding during operation, the amount of removed lymph nodes of the group of CADT was superior to those of the group of traditional surgical method （ all P 〈 0. 05 ）. The two groups were significantly different with statistical significance. Conclusions CADT is an efficient, practical and safe operation method used in breast cancer, lung cancer, and esophageal cancer surgery. It can reduce bleeding during surgery, accelerate the speed of the operation and improve the quality of the operation.