中下段食管癌胸腹腔镜联合根治术与传统三切口术的对比

Comparison of Thoracoscopic-Laparoscopic Esophagectomy and Traditional Three-Incision Esophagectomy for Middle-Lower Esophageal Cancer

目的前瞻性比较中下段食管癌胸腹腔镜联合根治术与传统三切口手术术后疼痛、淋巴结清扫及术后并发症情况,进一步明确胸腹腔联合食管癌根治术可行性及优势。方法选取2014年10月至2016年1月收入的Ⅰ—Ⅲ期食管癌患者60例,分别行胸腹腔镜联合食管癌根治术(TLE组)及传统三切口食管癌根治术(传统组),每组各30例。比较2组术后第1—14天术后疼痛(视觉模拟评分法(VAS))、清扫淋巴结数目及术后并发症情况。结果TLE组较传统组术后疼痛程度明显减轻,总淋巴结清扫数目及腹腔淋巴结清扫数目明显增多,术后呼吸系统并发症明显降低(均P<0.05);而胸腔淋巴结清扫数目、术后并发症发生率差异无统计学意义(P>0.05)。结论胸腹腔镜联合食管癌根治术具有减少疼痛创伤、恢复快、根治效果满意、呼吸系统并发症少的优点。

Objective To prospectively compare the pain,lymph node dissection and complications after thoracoscopic-laparoscopic esophagectomy(TLE)and traditional three-incision esophagectomy for middle-lower esophageal cancer,and to further clarify the feasibility and advantages of TLE.Methods Sixty stage Ⅰ-Ⅲ esophageal cancer patients admitted between October 2014 and January 2016 were selected in this study.These patients were assigned to receive either TLE(TLE group,n=30)or traditional three-incision esophagectomy(traditional group,n=30).VAS pain score,number of lymph nodes dissected and complications were observed in both groups during 1-14 postoperative days.Results Compared with traditional group,TLE alleviated postoperative pain,increased the total number of lymph nodes dissected and the number of abdominal lymph nodes dissected,and reduce postoperative pulmonary complications(P<0.05).No significant differences in the number of thoracic lymph nodes dissected and incidence of postoperative complications were found between the two groups(P>0.05).Conclusion The TLE can alleviate pain,accelerate recovery,improve treatment outcome and reduce respiratory complications in patients with middle-lower esophageal cancer.