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目的探讨二孔法电视胸腔镜手术(VATS)联合超声内镜(EUS)治疗食管平滑肌瘤的微创性和实用性。方法于2007年2月-2012年2月采用不同术式治疗食管平滑肌瘤患者166例,其中,62例应用传统常规开胸手术治疗(A组),49例采用传统三孔法VATS手术治疗(B组),55例采用二孔法VATS联合EUS治疗(C组);3组患者年龄、性别、病变位置及起源层次、病变大小等数据指标比较差异无统计学意义(P>0.05)。总结3组的临床指标并进行比较。结果 C组与A组出血量、手术时间、术中定位情况、术后切口疼痛情况、住院费用、住院时间、禁食时间、肺部感染及随访并发症等数据指标比较差异有统计学意义(P<0.05);C组与B组出血量、手术时间、术中定位情况、禁食时间、住院时间、住院费用及随访并发症等数据指标比较差异有统计学意义(P<0.05)。结论二孔法VATS联合EUS治疗食管平滑肌瘤具有微创、安全、彻底、并发症少等优点,值得临床推广。
Objective To investigate the minimal invasiveness and practicability of VATS combined with endoscopic ultrasonography (EUS) in the treatment of esophageal leiomyomata. Methods A total of 166 patients with esophageal leiomyoma were treated with different surgical procedures from February 2007 to February 2012. Of them, 62 cases were treated by conventional thoracotomy (group A) and 49 cases were treated by traditional three-hole VATS (Group B) and 55 patients were treated with two-hole VATS combined with EUS (group C). There was no significant difference in age, sex, location of disease, level of origin, size of lesion and other data between the three groups (P> 0.05). The clinical indicators of the three groups were summarized and compared. Results There were significant differences in the indexes of blood loss, operation time, intraoperative location, postoperative incision pain, hospitalization costs, length of hospital stay, fasting time, pulmonary infection and follow-up complications in group C and group A P <0.05). There was significant difference in the data of bleeding volume, operation time, intraoperative location, fasting time, hospital stay, hospitalization costs and follow-up complications in group C and group B (P <0.05). Conclusion Two-hole VATS combined with EUS in the treatment of esophageal leiomyoma has the advantages of minimally invasive, safe, thorough and less complications, which is worthy of clinical promotion.