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目的:探讨胸腔镜食管癌切除术式在食管癌治疗上的技术可行性和临床效果。方法:回顾分析2010年以来我科收治的98例食管癌手术患者的临床资料,胸腔镜手术为A组(32例),常规开胸为B组(66例),比较两组在胸部手术时间、胸部手术出血量、术后ICU时间、术后疼痛评分、术后住院时间、围术期并发症、围术期死亡及胸部淋巴结切除数量等方面的差异。结果:A组患者胸部手术时间、胸部手术出血量、胸部淋巴结切除数量与B组差异无统计学意义,但在术后ICU时间、疼痛评分、住院时间、肺部并发症及总的围术期并发症发生率方面明显优于B组(均P<0.05);吻合口瘘、喉返神经损伤、房颤发生率与B组差异无统计学意义,但肺部并发症发生率明显低于B组(P<0.05)。结论:胸腔镜下左侧卧位食管癌根治手术不但减少了对患者的创伤,降低了术后并发症发生率,而且在淋巴结清扫上与开胸手术无差异。
Objective: To investigate the technical feasibility and clinical effect of thoracoscopic esophagectomy in the treatment of esophageal cancer. Methods: The clinical data of 98 patients with esophageal cancer treated in our department since 2010 were analyzed retrospectively. Thoracoscopic surgery was performed in group A (32 cases) and conventional thoracotomy in group B (66 cases). Thoracic surgery was performed on thoracic surgery , The amount of bleeding during thoracic surgery, postoperative ICU time, postoperative pain score, postoperative hospital stay, perioperative complications, perioperative mortality and the number of resected thoracic lymph nodes. Results: There was no significant difference between the two groups in the number of chest operation, the amount of thoracic surgery, and the number of resected thoracic lymph nodes in group A, but the ICU time, pain score, length of hospital stay, pulmonary complications and total perioperative period The incidence of complications was significantly better than that of group B (all P <0.05). There was no significant difference between anastomotic fistula, recurrent laryngeal nerve and atrial fibrillation in group B, but the incidence of pulmonary complications was significantly lower than that in group B Group (P <0.05). Conclusions: Thoracoscopic radical surgery for left esophageal cancer in the left lateral position not only reduces the trauma to the patient, but also reduces the incidence of postoperative complications. There is no difference between the thoracoscopic surgery and the thoracotomy in lymph node dissection.