充气式纵隔腔镜与微创McKeown手术治疗食管癌的效果评价

Effect evaluation of inflatable mediastinoscopy and minimally invasive McKeown surgery in the treatment of patients with esophageal cancer

目的比较充气式纵隔腔镜与微创McKeown手术治疗食管癌的效果。方法选取108例行微创手术治疗的食管癌患者,其中纵隔腔镜组(n=30)采取充气式纵隔腔镜同步腹腔镜食管癌手术,微创McKeown组(n=78)采取胸腹腔镜联合食管癌手术。比较2组患者的相关临床资料以及术中、术后疗效指标。结果纵隔腔镜组患者的手术时间、首次下床时间、留置胃管时间、术后禁食时间和住院时间均显著短于微创McKeown组(P <0. 05)。纵隔腔镜组切缘阳性率为0%,显著低于微创McKeown组的12. 82%(P <0. 05)。纵隔腔镜组术后疼痛程度显著轻于微创McKeown组(P <0. 05)。纵隔腔镜术后并发症发生率为6. 67%,显著低于微创McKeown组的24. 36%(P <0. 05)。结论充气式纵隔腔镜治疗食管癌的手术创口小,术后疼痛轻,术后并发症较少。

Objective To compare the effect of inflatable mediastinoscopy and minimally invasive McKeown surgery on the treatment of patients with esophageal cancer. Methods The 108 patients with minimally invasive operation for esophageal cancer were divided into mediastinoscopy group （ n =30, treated with inflatable mediastinoscopy and synchronous laparoscopy） and minimally invasive McKeown group （ n =78, treated with thoracoscopic laparoscopy combined with esophageal cancer surgery）. The clinical materials, the intra-operative and postoperative indexes were compared between the two groups. Results The operation time, the primary time to get out of bed, indwelling time of gastric tube, postoperative fasting time, and hospital stay in the mediastinoscopy group were significantly shorter than those in the minimally invasive McKeown group （ P 〈0.05）. The rate of positive margins in the mediastinoscopy group was 0%, which was significantly lower than 12.82% in the minimally invasive McKeown group （ P 〈0.05）. The degree of pain in the mediastinoscopy group was significantly lower than that in the minimally invasive McKeown group （ P 〈0.05）. The incidence rate of postoperative complications in the mediastinoscopy group was 6.67%, which was significantly lower than 24.36% in the minimally invasive McKeown group （ P 〈0.05）. Conclusion For the treatment of patients with esophageal cancer, inflatable mediastinoscopy has small surgical trauma, less postoperative pain and lower incidence rate of postoperative complications.