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目的 :探讨胸腹腔镜(TLE)与Ivor Lewis(ILE)手术治疗食管癌在围手术期的安全性及可行性。方法 :符合入组条件的食管癌患者随机分为TLE组和常规ILE组。比较两组总的淋巴结清扫数目、淋巴结转移率、手术时长、出血量、术后胸腔引流量、术后住院天数、术后并发症。结果:2011年5月至2014年5月,共招募150例患者,其中TLE组75例,ILE组75例,TLE和ILE手术组在手术时长、术中出血量、术后胸腔引流量、术后住院天数等方面差异具有统计学意义(P<0.05);术后并发症、淋巴结清扫数目和转移率,差异均无统计学意义(P>0.05)。结论:虽然手术时间较长,但并发症及淋巴结清扫相似,且TLE减少了出血量、胸腔引流量及住院天数,这些结果显示TLE是安全可行的。
Objective: To investigate the perioperative safety and feasibility of thoracic laparoscopy (TLE) and Ivor Lewis (ILE) in the treatment of esophageal cancer. Methods: Patients with esophageal cancer who met the criteria were randomly divided into TLE group and conventional ILE group. The total number of lymph node dissection, lymph node metastasis rate, operation time, blood loss, postoperative chest drainage, postoperative hospital stay and postoperative complications were compared between the two groups. Results: From May 2011 to May 2014, a total of 150 patients were enrolled. Among them, 75 patients in TLE group and 75 in ILE group were enrolled in this study. The duration of operation, blood loss, postoperative thoracic drainage, (P <0.05). There were no significant differences in postoperative complications, number of lymph node dissection and metastasis rate between the two groups (P> 0.05). CONCLUSION: Although the operation time is longer, complications and lymph node dissection are similar, and TLE reduces the amount of bleeding, chest drainage and length of hospital stay. These results show that TLE is safe and feasible.