胸腹腔镜联合手术治疗食管癌的临床分析

Clinical analysis of thoracoscopic laparoscopic surgery in treatment of esophageal carcinoma

目的客观评价胸腹腔镜联合手术治疗食管癌的近期临床疗效和安全性。方法回顾性分析行胸腹腔镜联合手术的93例食管癌(微创组)和同期行常规开放性手术的104例食管癌患者(开放组)的临床资料,分析其根治性及近期临床疗效差异。结果两组患者在性别、年龄和TNM分期等一般资料方面比较,差异均无统计学意义(均P>0.05)。微创组手术时间较开放组长(P<0.01),而在出血量、胸腔引流量以及胸管置留时间和住院时间方面优于开放组(均P<0.05)。微创组与开放组在淋巴结处理数、术后淋巴结转移率及胸腹腔淋巴结转移枚数方面比较,差异均有统计学意义(均P<0.05)。结论胸腹腔镜联合食管癌手术安全可行,根治性较好,近期疗效可靠。

Objective To evaluate the short-term clinical efficacy and safety of thoracoscopic laparoscopic surgery in the treatment of esophageal cancer. Methods The clinical data of 93 patients with esophageal carcinoma who underwent thoracoscopic laparoscopic surgery（minimally invasive group） and 104 patients who underwent conventional open surgery（open surgery group） were analyzed retrospectively. The radical and short-term efficacies were compared between two groups. Results No significant difference was observed in gender,age and TNM stages between two groups（all P〈0. 05）. The minimally invasive group was superior to the open surgery group in terms of blood loss,thoracic drainage volume,thoracic drainage duration and hospitalization duration（all P〈0. 05）,but it had longer operation time（P〈0. 01）.The minimal invasive group had more dissected lymph nodes,lower postoperative metastasis rates and less metastatic thoracic and abdominal lymph nodes than the open surgery group（all P〈0. 05）. Conclusion Thoracoscopic laparoscopic surgery has high radical rate and reliable short-term clinical efficacy and high safety in the treatment of esophageal carcinoma.