电视胸腔镜辅助下食管癌切除术与常规开胸手术对比研究(附45例报告)

Comparative study of modified video-assisted thoracic surgery versus routine open thoracotomy in esophageal carcinoma

目的 显示改良电视胸腔镜食管癌切除术较常规开胸手术具有优越性。方法 施行改良电视胸腔镜食管癌切除术 4 5例 (研究组 ) ,同期施行常规开胸手术 4 5例 (对照组 ) ,两组病人均以T3 N1M0 期患者为多数。比较两组患者围术期情况。结果 研究组与手术组比较 ,手术效果满意。手术时间 [分别为 (2 8.6 8±4 .90 ) ,(5 9.73± 6 .0 6 )min],胸部失血量 [分别为 (92 .72± 18.5 6 ) ,(14 5 .0 1± 35 .4 2 )ml],术后引流量 [第 1天分别为 (2 0 1.36± 4 4 .6 5 ) ,(2 95 .4 5± 5 7.2 2 )ml]均有显著差异 (P <0 .0 0 1)。结论 改良电视胸腔镜食管癌切除术具有手术时间短、创伤小、出血少、疼痛轻、恢复快、并发症少等优点 ,令人满意。

Objective:To show advantage of Modified Video-Assisted surgery(VATS) compared with routine open thoracotomy for resection of carcinoma of the esophagus.Methods:Forty-five cases received video-assisted surgery(test group),during the same period ,45 cases underwent routine open thoracotomies(control group);A cervical esophagogastrostomy is made.Results: There was no operative mortality in two groups.The mean thoracic operating time was (28.68±4.90 )min for test group and(59.73±6.06)min for control group. The mean thoracic operating blood loss was(92.72±18.56)ml for test group and (145.01±35.42)ml for control group,The mean chest tube drainage was (201.36±44.65)ml for test group and (295.45 ±57.22)ml for control group in the first day after operation. The difference in above parameters between two groups was significant (all P <0.001).Conclusions:It is suggested that VATS is a safe ,less traumatic procedure in the treatment of esophagus carcinoma.