论文部分内容阅读
目的探讨中晚期食管癌行胸腔镜食管癌根治术治疗的临床疗效。方法选取2012年1月至2014年12月间南京医科大学附属淮安一院收治的178例中晚期食管癌患者,按其手术方式分为胸腔镜食管癌根治组(100例),三切口食管癌根治开放组(78例)。记录患者术中情况、术后拔管时间、住院费用、并发症发生情况及复发率和死亡率。结果两组患者均顺利完成手术,胸腔镜组无中转开胸病例,围术期两组均无死亡病例。胸腔镜组平均术中出血量(158.5±26.5)ml、引流时间(4.5±1.5)d、引流量(470.0±250.0)ml、平均住院时间(12.5±2.5)d和并发症发生率为20.0%,均优于开放组的(176.5±28.5)ml、(7.5±2.5)d、(900.0±360.0)ml、(16.5±3.5)d和29.5%,两组比较差异均有统计学意义(均P<0.05)。胸腔镜组淋巴结清扫数量(22.8±6.8)枚、阳性淋巴结率(9.5±1.5)%、手术时间(158.5±26.5)min和住院费用(5.5±0.3)万元,与开放组的(23.7±7.0)枚、(9.6±1.5)%、(176.5±28.5)min和(5.3±0.2)万元比较,差异均无统计学意义(均P>0.05)。胸腔镜组患者复发或转移9例(9.0%),开放组为10例(12.8%),组间比较差异无统计学意义(P>0.05)。胸腔镜组患者死亡3例(3.0%),开放组患者死亡4例(5.1%),组间比较差异无统计学意义(P>0.05)。胸腔镜组总生存率为97.0%,开放组为94.9%,组间比较差异无统计学意义(P>0.05)。结论胸腔镜下治疗中晚期食管癌临床疗效理想,术后恢复快,术后并发症发生率低,适于临床上使用。
Objective To investigate the clinical effect of thoracoscopic esophagectomy for the treatment of advanced esophageal cancer. Methods A total of 178 patients with advanced esophageal cancer who were admitted to Huai’an First Affiliated Hospital of Nanjing Medical University from January 2012 to December 2014 were selected and divided into thoracoscope esophageal cancer radical group (100 cases), triple incision esophageal cancer Radical group (78 cases). Record the patient’s intraoperative situation, postoperative extubation time, hospitalization costs, complications and recurrence rate and mortality. Results The two groups of patients were successfully completed surgery, thoracoscopic group without transfer thoracotomy cases, no deaths in both groups during the perioperative period. The average intraoperative blood loss (158.5 ± 26.5) ml, drainage time (4.5 ± 1.5) days, drainage volume (470.0 ± 250.0) ml, average length of hospital stay (12.5 ± 2.5) days and complication rate were 20.0% (176.5 ± 28.5) ml, (7.5 ± 2.5) d, (900.0 ± 360.0) ml, (16.5 ± 3.5) d and 29.5% in the open group, respectively, with significant difference between the two groups <0.05). The number of lymph node dissection in thoracoscopic group (22.8 ± 6.8), positive lymph node rate (9.5 ± 1.5)%, operation time (158.5 ± 26.5) min and hospitalization cost (5.5 ± 0.3) ), (9.6 ± 1.5)%, (176.5 ± 28.5) min and (5.3 ± 0.2) million respectively, with no significant difference (all P> 0.05). There were 9 cases (9.0%) in the thoracoscopic group and 10 cases (12.8%) in the open group. There was no significant difference between the two groups (P> 0.05). There were 3 deaths in thoracoscopic group (3.0%) and 4 deaths (5.1%) in open group. There was no significant difference between the two groups (P> 0.05). The total survival rate was 97.0% in thoracoscopic group and 94.9% in open group, there was no significant difference between the two groups (P> 0.05). Conclusions Video-assisted thoracoscopic treatment of advanced esophageal cancer has an ideal clinical outcome, rapid postoperative recovery and low postoperative complication rate, which is suitable for clinical use.