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目的评价胸腹腔镜下早期食管癌根治术的临床应用价值。方法选择我院2010年6月至2011年12月接受胸腹腔镜(n=56)和传统开胸(n=53)行食管癌根治术的病例资料,比较两组患者的术中情况、术后并发症、复发或转移率、病死率及随访情况等差别。结果腔镜组的手术时间长于开胸组,但失血量、住院时间、转ICU病例数、胸液引流时间、胸液引流量等方面优于开胸组,差异有统计学意义(P<0.05)。两组的淋巴结清扫数量、阳性淋巴结率差异无统计学意义。腔镜组术后总并发症发生率8.9%,少于开胸组的11.3%,但差异无统计学意义。两组随访3～21个月,腔镜组复发或转移率为5.7%,生存率98.1%;开胸组复发或转移率8.3%,生存率为97.9%;两组在复发或转移率及生存率等方面差异无统计学意义。结论应用胸腔镜联合腹腔镜行食管癌根治术创伤小、并发症少、恢复快,具有与开胸手术相当的近期疗效,是一种安全、可行、临床效果好的微创术式。
Objective To evaluate the clinical value of thoracoscopic laparoscopic radical mastectomy for early esophageal cancer. Methods The data of patients underwent thoracoscopic (n = 56) and conventional thoracotomy (n = 53) radical esophagectomy from June 2010 to December 2011 in our hospital were selected. The intraoperative results of two groups were compared Postoperative complications, recurrence or metastasis, mortality and follow-up differences. Results The operation time of laparoscopic group was longer than that of thoracotomy group, but the blood loss, length of hospital stay, number of ICU cases, drainage time of pleural effusion and drainage volume of pleural effusion were superior to those of thoracotomy group (P <0.05 ). There was no significant difference between the two groups in the number of lymph node dissection and the positive lymph node rate. The incidence of postoperative complications in endoscopic group was 8.9%, less than 11.3% in thoracotomy group, but the difference was not statistically significant. The recurrence or metastasis rate was 5.7% in the endoscopic group and 98.1% in the open group. The recurrence or metastasis rate was 8.3% in the thoracotomy group and the survival rate was 97.9%. The recurrence or metastasis rate and survival rate Rate and other aspects of the difference was not statistically significant. Conclusions Thoracoscopy combined with laparoscopic esophagectomy is a safe, feasible and minimally invasive minimally invasive surgical treatment of esophageal cancer with less trauma, less complications and faster recovery. It has the same short-term curative effect as thoracic surgery.