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目的总结单操作孔胸腔镜联合腹腔镜食管癌根治颈部三角吻合术的临床效果。方法回顾性分析胸腔镜联合腹腔镜食管中下段癌根治颈部吻合术66例的资料,比较单操作孔胸腔镜颈部三角吻合30例(单孔组)和四孔胸腔镜颈部管状吻合36例(四孔组)的临床效果。结果 66例均顺利完成手术。单孔组术后VAS疼痛评分低于四孔组[(3.43±1.14)分vs.(4.31±1.53)分](P<0.05)。单孔组术后未发现吻合口狭窄发生;四孔组吻合口狭窄发生率为16.7%(6/36)(P<0.05)。两组在中转开胸、手术时间、术中出血量、淋巴结清扫数、胸腔引流管拔出时间、吻合口瘘发生率方面均无统计学差异(P>0.05)。结论单操作孔胸腔镜联合腹腔镜食管癌根治颈部三角吻合术安全可行;其吻合口大小不受食管和胃内径限制,近期疗效满意。
Objective To summarize the clinical effects of single-operation hole thoracoscope combined with laparoscopic esophagectomy for cervical trigeminal anastomosis. Methods A retrospective analysis was made on the data of 66 cases of thoracoscopic combined laparoscopic radical anastomosis of the lower esophagus undergoing neck anastomosis. Thirty patients (single hole group) underwent thoracoscope neck thoracic anastomosis and thoracoscope neck thoracic anastomosis 36 Case (four-hole group) clinical effect. Results 66 cases were successfully completed the operation. VAS pain score in the single-hole group was lower than that in the four-hole group (3.43 ± 1.14 vs 4.31 ± 1.53) (P <0.05). No anastomotic stenosis occurred in the single hole group. The incidence of anastomotic stenosis in the four-hole group was 16.7% (6/36) (P <0.05). There was no significant difference between the two groups (P> 0.05) in transit thoracotomy, operation time, intraoperative blood loss, lymph node dissection number, chest drainage time, anastomotic fistula incidence. Conclusions Single-hole thoracoscope combined with laparoscopic esophagectomy for cervical trigeminal anastomosis is safe and feasible. The anastomotic size is not limited by esophageal and gastric diameter, and the short-term curative effect is satisfactory.