腹腔镜游离胃与传统胸腹两切口在中段食管癌手术中的比较

Comparison on operative outcomes of laparoscopic or traditional approach in treatment of middle segment esophageal cancer

目的:探讨2种食管中段癌根治术对患者术后总体情况的影响,同时比较2种手术方式的差别。方法:回顾性分析某院收治的72例食管中段癌患者临床资料,根据手术方式不同分成观察组和对照组,观察组采用腹腔镜游离胃开放进胸食管中段癌根治术,对照组采用传统胸腹两切口开放食管中段癌根治术。观察比较2组患者在手术时间、腹部手术时间、术中出血量、淋巴结清扫个数、术后引流量、术后疼痛程度、胸腔引流管拔出时间、术后并发症、胃肠恢复时间以及住院天数的差异。结果:观察组总手术时间、腹部手术时间、术后住院时间较对照组明显缩短(P<0.05);2组比较观察组术中出血量、术后引流量较对照组明显减少,差异有统计学意义(P<0.05);观察组疼痛程度减轻、胃肠功能恢复提前(P<0.05);2组患者术后吻合口漏的发生情况、淋巴结清扫个数、术后胸管拔出时间比较,差异无统计学意义(P>0.05);观察组术后切口感染率、肺部感染率较对照组低,2组比较差异有统计学意义(P<0.05)。结论:与传统胸腹两切口手术方式相比,腹腔镜游离胃开放进胸食管中段癌根治可以明显减少手术时间及术中出血量,患者术后恢复更快且并发症明显降低。

Objective： To investigate the effects of two kinds of middle segment esophageal cancer resection on the overall postopera- tire condition of patients and to compare the differences of the two surgical methods. Methods ： Retrospective analysis was conducted on the clinical data of 72 cases of esophageal cancer treated in a hospital. The 72 patients were divided into an observation group and a control group and two different surgical methods were adopted on them. Data of the two groups including operation time, abdominal sur- gery time,intraoperative blood loss, and so on were observed and compared. Results：The operation time, the abdominal operation time, and the time of hospital stay of the observation group were significantly shortened （ P 〈 0.05 ） , and the amount of bleeding during operation was significantly decreased （ P 〈 0.05 ）. There was no significant difference in the number of the lymph node dissection, anastomotic leakage and tubal pull-out time between the two groups （ P 〉 0.05 ）. The postoperative drainage, pain, the recovery of gastrointestinal function, the incision infection rate and the lung infection rate of the observation group were superior to the control group. Conclusion ： Compared with the traditional chest and abdomen incision approach, laparoscopic assisted middle segment esophageal cancer treatment can significantly reduce the operation time, intraoperative blood loss, and postoperative complications. Patients can recover faster.