河北医科大学学报

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微创食管癌根治术与常规开胸手术治疗食管癌的安全性及效果比较

  

  1. 河北北方学院附属第一医院胸外科,河北 张家口 075000
  • 出版日期:2018-02-25 发布日期:2018-02-06
  • 作者简介:容宇(1985-),男,河北石家庄人,河北北方学院附属第一医院主治医师,医学硕士,从事胸外科疾病诊治研究。

Comparison of the safety and therapeutic effect of minimally invasive esophagectomy and routine thoracotomy in the treatment of esophageal cancer#br#

  1. Department of Thoracic Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Online:2018-02-25 Published:2018-02-06

摘要: [摘要]〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨微创食管癌根治术治疗食管癌的安全性及效果。
〖HTH〗方法〖HTSS〗〖KG*2〗选取0~Ⅲb期食管癌患者123例,根据患者意愿分为微创食管癌根治术组68例和常规开胸手术组55例,比较2组手术时间、术中出血量、胸腔引流量、术后胸管留置时间、术后开始进食时间、术后疼痛程度、淋巴结清扫个数以及各类并发症发生率,分析患者1年无瘤生存率及总生存率。
〖HTH〗结果〖HTSS〗〖KG*2〗微创组手术时间明显长于开胸组,术中失血量、术后胸腔引流量少于开胸组,术后胸管留置时间、术后开始进食时间短于开胸组,术后疼痛程度低于开胸组,淋巴结清扫个数多于开胸组(P<005)。微创组肺部感染发生率低于开胸组(P<005),2组吻合口瘘、脓胸、乳糜胸、声音嘶哑、吻合口狭窄发生率差异均无统计学意义(P>005)。微创组术后1年无瘤生存率高于开胸组(P<005),2组1年总生存率差异无统计学意义(P>005)。
〖HTH〗结论〖HTSS〗〖KG*2〗微创食管癌根治术较常规开胸手术损伤小、安全性高,对提高患者无瘤生存期有益。

关键词: 食管肿瘤, 微创手术, 常规开胸手术

Abstract: [Abstract]〓Objective〖HTSS〗〓To investigate the safety and therapeutic effect of minimally invasive esophagectomy(MIE) for esophageal cancer.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓One hundred and twentythree cases of esophageal cancer in stage 0-Ⅲb were divided into MIE group with 68 cases and conventional thoracic surgery group with 55 cases according to their wishes. Operation time, bleeding volume, drainage volume of thoracic, chest drainage tube placement time, the time of beginning taking food, the level of post operation pain, the number of lymph node dissection and incidence of complications were compared between the two groups. Oneyear diseasefree survival rate and oneyear overall survival rate were analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The MIE group had significantly higher operation time, less bleeding volume, less chest drainage volume,shorter drainage tube placement time,shorter beginning taking food time,lighter operative pain,more number of the lymph node dissection than the conventional thoracic surgery group(P<005). The incidence of postoperative pulmonary infection in MIE group were lower than the conventional thoracic surgery group(P<005). The incidence rate of anastomotic fistula, empyema, chylothorax, hoarseness and anastomotic stenosis had no statistics significancebetween the two groups(P>005). Oneyear diseasefree survival rate in MIE group was higher than the conventional thoracic surgery group(P<005) and oneyear overall survival rate had no statistics significancebetween the two groups(P>005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The MIE has smaller damage and higher safety than conventional thoracic surgery, and it also can improve the diseasefree survival rate.

Key words: esophageal neoplasms, minimally invasive surgery, routine thoracotomy