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目的比较胸腹腔镜联合食管癌根治术和传统开胸手术治疗食管癌淋巴结清扫的效果。方法 100例食管癌患者,按手术方式不同分为研究组和对照组,每组50例。研究组实施胸腹腔镜联合食管癌根治术,对照组实施传统开放食管癌根治术。比较两组患者的手术效果。结果研究组术中出血量、术中输液量、术后住院时间、留置胃管时间、重症加强护理病房(ICU)监护时间、术后禁食时间均优于对照组,差异均具有统计学意义(P<0.05);研究组手术用时长于对照组,差异具有统计学意义(P<0.05);两组术中输血、手术室拔管比率比较差异均无统计学意义(P>0.05)。术后研究组并发症发生率为18%,低于对照组的56%,差异具有统计学意义(P<0.05)。两组清扫淋巴结个数及切缘阳性比率比较差异均无统计学意义(P>0.05)。结论胸腹腔镜联合食管癌根治术治疗食管癌与传统开胸手术相比能够达到更为理想的治疗效果,且能够达到足够的肿瘤切除范围与淋巴结清扫范围,在临床上值得推广应用。
Objective To compare the effect of thoraco-laparoscopic combined with esophagectomy and conventional thoracotomy for the treatment of lymph node dissection in esophageal cancer. Methods 100 cases of esophageal cancer patients were divided into study group and control group according to different surgical methods, 50 cases in each group. The study group performed thoracic and laparoscopic radical resection of esophageal cancer and the control group received conventional open esophagectomy. The surgical results of two groups were compared. Results The intraoperative blood loss, intraoperative infusion, postoperative hospital stay, indwelling gastric tube time, intensive care unit (ICU) monitoring time, postoperative fasting time were better than the control group, the difference was statistically significant (P <0.05). The duration of operation in the study group was longer than that in the control group (P <0.05). There was no significant difference in the rate of blood transfusion and operation room extubation between the two groups (P> 0.05). The postoperative complication rate was 18% in the study group, which was lower than 56% in the control group (P <0.05). There was no significant difference in the number of lymph nodes and the positive rate of margins between the two groups (P> 0.05). Conclusions Laparoscopic and esophagectomy combined with esophagectomy for the treatment of esophageal cancer can achieve more satisfactory curative effect than conventional thoracotomy, and can reach enough range of tumor resection and lymph node dissection, which is worth popularizing and applying in clinic.