论文部分内容阅读
目的:评价胸腔镜Mc Keown食管癌根治术的安全性、可行性和近期疗效。方法:回顾性分析2013年1月—2014年2月南京医科大学附属江宁医院胸外科收治的25例接受胸腔镜Mc Keown食管癌根治术患者的临床资料,并与同期行开放食管癌根治术的30例患者对照分析,比较两组患者的术前基本资料、围手术期相关结果及术后并发症发生率。结果:两组患者术前资料方面无明显差异。胸腔镜组的术中出血量、术后胸腔引流时间及术后ICU治疗人数均较开放组患者低(P<0.05),而手术时间长于开放组(P<0.05)。两组患者在淋巴结清扫数量、术后TNM分期、围手术期病死率(30 d)及术后住院时间方面无明显差异(P>0.05)。术后并发症的观察方面,两组患者房颤、喉返神经麻痹、吻合口瘘及乳糜胸的发生率无明显差异(P>0.05)。胸腔镜组术后呼吸系统并发症发生率低于开放根治组,差异有统计学意义(P<0.05)。结论:胸腔镜行食管癌手术是安全可行的,并且具有创伤小、术中出血少及术后肺部并发症少的优点。
OBJECTIVE: To evaluate the safety, feasibility and short-term efficacy of thoracoscopic Mc Keown esophagectomy. Methods: The clinical data of 25 patients undergoing thoracoscopic Mc Keown esophageal cancer radical resection admitted from Jan. 2013 to Feb. 2014 in Jiangning Hospital of Nanjing Medical University were analyzed retrospectively. The clinical data of radical resection of esophageal cancer Thirty patients were compared and analyzed. The basic preoperative data, perioperative outcomes and incidence of postoperative complications were compared between the two groups. Results: There was no significant difference in preoperative data between the two groups. The intraoperative blood loss, postoperative thoracic drainage time and postoperative ICU treatment were significantly lower in the thoracoscopic group than those in the open group (P <0.05), but the operation time was longer than that in the open group (P <0.05). There was no significant difference between the two groups in the number of lymph node dissection, postoperative TNM stage, perioperative mortality (30 days) and postoperative hospital stay (P> 0.05). There were no significant differences in the incidence of postoperative complications between the two groups in atrial fibrillation, recurrent laryngeal nerve paralysis, anastomotic fistula and chylothorax (P> 0.05). The incidence of postoperative respiratory complications in thoracoscopic group was significantly lower than that in open radical group (P <0.05). Conclusion: Thoracoscopic esophageal cancer surgery is safe and feasible, and has the advantages of less trauma, less intraoperative bleeding and less postoperative pulmonary complications.