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目的探讨腹腔镜游离胃代替常规开腹手术在食管癌根治术中的优点。方法将136例食管癌手术患者分腹腔镜组和常规开腹组。分析两组腹部手术时间、腹腔引流液量、腹部切口感染率、肺部感染发生率、腹腔淋巴结清除数量、胃肠功能恢复情况、术后胃壁坏死、胃残端瘘发生率。结果与常规开腹组相比,腹腔镜组具有腹部手术时间短、失血量小、腹部无切口感染、术后肺部感染发生率低的优点,其中手术时间和腹腔出血量两组相比,差异具有高度统计学意义(均P<0.01)。术后胃肠功能恢复、腹腔淋巴结清除数量无明显差异,同时不会增加术后胃壁坏死、胃残端瘘发生率。结论腹腔镜游离胃在食管癌根治术中具有明显优点,值得在临床上推广。
Objective To explore the advantages of laparoscopic free stomach instead of conventional laparotomy in esophagectomy. Methods 136 cases of esophageal cancer patients were divided into laparoscopic group and conventional laparotomy group. The time of abdominal operation, fluid drainage in abdominal cavity, infection rate of abdominal incision, incidence of pulmonary infection, number of lymph node clearance in abdominal cavity, recovery of gastrointestinal function, postoperative stomach wall necrosis and gastric stump fistula were analyzed. Results Compared with the conventional laparotomy group, laparoscopic group had the advantages of short operative time of abdominal surgery, small amount of blood loss, no incision infection in the abdomen and low incidence of postoperative pulmonary infection. Compared with the two groups, The difference was highly statistically significant (P <0.01). After gastrointestinal function recovery, the number of abdominal lymph node clearance no significant difference, while not increase the postoperative gastric wall necrosis, gastric stump fistula incidence. Conclusion Laparoscopic free stomach in esophageal cancer radical surgery has obvious advantages, it is worth in the clinical promotion.