胸腔镜与开放式食管下段癌根治术的效果比较

Comparison of the effect of open lower esophageal cancer radical surgery with the thoracic cavity

目的比较胸腔镜与开放式食管下段癌患根治术的效果。方法收集食管下段癌患者86例,根据平行、单盲、随机对照的设计原则分为对照组(43例)和观察组(43例),对照组患者接受开放上腹右胸手术,观察组接受胸腔镜食管下段癌根治术,并对两组患者的术中出血量、术后胸引管留置时间、术后胸腔引流量、术后3年生存率、淋巴结清扫情况、术后并发症发生率进行对比。结果观察组术中出血量、术后胸引管留置时间、术后胸腔引流量均明显优于对照组(P<0.05),术后3年生存率两组比较无明显差异(P>0.05);观察组的淋巴结清扫情况与术后并发症发生率与对照组相比,差异均不显著(P>0.05)。结论在食管下段癌患者的治疗过程中,胸腔镜根治术能在保证治疗效果的基础上提高手术治疗的安全性,患者更加受益,可在临床推广应用。

Objective To study and analyze the effect of the treatment of patients with lower esophageal cancer by using the thoracic or open esophageal cancer. Methods 86 esophageal cancer patients were collected in the present study. The patients were divided into control group （43 cases） and observation group （43 cases）. The patients in the control group received open esophageal cancer radical surgery. The observation group received thoracoscopic esophageal cancer radical surgery. The operative time, bleeding, postoperative chest tube indwelling time, postoperative chest drainage, lymph node dissection, postoperative complication rate were observed. Results The intraoperative bleeding volume, postoperative chest tube drainage time, postoperative chest drainage volume of observation group were significantly better than that of the control group （P〈0.05）. The lymph node dissection, the three-year survival rate and postoperative complication rate of observation group and the control group had no significant difference （P〉0.05）. Conclusion Radical surgery can improve the safety of surgical treatment on the basis of the effect of treatment of patients with lower esopha- geal cancer.