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目的探讨胸腔镜下行食管癌切除术疗效及可行性。方法术前判断分期T3N1M0以下食管癌患者100例,随机分为胸腔镜组42例于胸腔镜下行食管癌切除术,开胸组58例行常规开胸手术。比较2组清扫淋巴结数、胸部出血量、手术时间、住院时间、住院费用、术后人均镇痛次数、术后第1天胸腔引流量、术后并发症发生率及围术期病死率、3a生存率。结果胸腔镜组1例因术中发现肿瘤侵及周围器官中转行开胸手术。2组清扫淋巴结数目、吻合口瘘及切缘癌残留发生率、围手术期病死率、3a生存率比较差异无统计学意义(P>0.05),胸部出血量、手术时间、住院时间、住院费用、术后人均镇痛次数、术后第1天胸腔引流量、术后并发症发生率比较差异有统计学意义(P<0.05)。结论胸腔镜下行食管癌切除术安全、有效,且创伤小、术后恢复快。
Objective To investigate the efficacy and feasibility of thoracoscopic esophagectomy. Methods One hundred patients with esophageal cancer below T3N1M0 were randomly divided into thoracoscope group (42 cases) and thoracoscopic esophagectomy group (58 cases). Thoracotomy group (58 cases) underwent conventional thoracotomy. The number of lymph nodes, thoracic blood loss, operation time, hospitalization time, hospitalization cost, the number of postoperative analgesia, the amount of chest drainage on the first postoperative day, the incidence of postoperative complications and perioperative mortality were compared between the two groups Survival rate. Results One case of thoracoscopy group was found to be involved in tumor invasion and peripheral organs in the thoracotomy. There was no significant difference in the number of lymph node dissection, anastomotic fistula, margin residual rate, perioperative mortality and 3a survival rate between the two groups (P> 0.05), the amount of thoracic blood loss, operation time, hospital stay, hospitalization cost , Postoperative average number of postoperative analgesia, chest drainage on the first postoperative day, postoperative complication rate was significantly different (P <0.05). Conclusions Video-assisted thoracoscopic esophageal cancer resection is safe and effective, with less trauma and rapid postoperative recovery.