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目的探讨微创McKeown术治疗食管癌的疗效,并与左侧开胸食管切除术比较,为食管癌手术方案的制定提供依据。方法根据术式将2009年1月至2013年6月收治的78例食管癌患者分为微创组(38例)和开胸组(40例),分别接受微创McKeown术和左侧开胸食管切除术并行胸腹部淋巴结清扫,分析两组的围术期指标和淋巴结清扫情况,同时记录术后并发症情况。结果微创组的术中出血量和术后住院时间分别为(91.58±13.76)ml和(11.73±3.26)d,低于开胸组的(335.74±73.51)ml和(13.64±4.19)d,差异均有统计学意义(P<0.05),微创组的总体淋巴结清扫个数及胸部淋巴结个数均多于开胸组(P<0.05)。结论微创McKeown术治疗食管癌的安全性较好,降低了术中出血,减少了术后住院时间,且淋巴结清扫情况优于左侧开胸食管切除术。
Objective To investigate the curative effect of minimally invasive McKeown in the treatment of esophageal cancer and compare with the left thoracotomy for esophagectomy to provide the basis for the development of esophageal cancer surgical plans. Methods According to the surgical procedure, 78 patients with esophageal cancer who were treated from January 2009 to June 2013 were divided into minimally invasive group (38 cases) and thoracotomy group (40 cases), receiving minimally invasive McKeown operation and left thoracotomy Esophagectomy parallel chest and abdomen lymph node dissection, analysis of the two groups of perioperative indicators and lymph node dissection, while recording the postoperative complications. Results The blood loss and postoperative hospital stay in the minimally invasive group were (91.58 ± 13.76) ml and (11.73 ± 3.26) days, respectively, which were lower than those in the thoracotomy group (335.74 ± 73.51) ml and (13.64 ± 4.19) days, (P <0.05). The number of lymph nodes dissection and the number of thoracic lymph nodes in minimally invasive group were more than those in thoracotomy group (P <0.05). Conclusion Minimally invasive McKeown is superior to esophageal cancer in the treatment of esophageal cancer, reducing intraoperative bleeding, reducing postoperative hospital stay, and lymph node dissection is superior to the left thoracotomy.