摘要
目的 探讨手辅助电视胸腔镜行食管癌切除术的可行性及优缺点。方法 对 45例术前判断分期T3N1MO以下食管癌患者行手辅助电视胸腔镜食管癌切除术 (研究组),同期施行常规开胸手术 45例(对照组),比较两组患者术中淋巴结清扫情况及围手术期情况。结果 研究组手术效果满意。研究组和对照组手术清扫的食管旁淋巴结分别为(3 .6±1. 0)和 (3 .3±1 .5)个,贲门旁淋巴结分别为(1 .3±1 .1)和(1. 6±1 .1)个,胃左动脉周围淋巴结分别为 (4 .3±1 .4)和 (4. 7±2. 1)个,两组差异无统计学意义(P>0 .05);隆突下淋巴结分别为(6 .6±3. 7)和(3 .8±2 .5)个,研究组好于对照组(χ2 =2 95,P<0 05)。研究组与对照组手术时间分别为 (29±5)和 (60±6)min,胸部失血量分别为(93±19)和(145±35)ml,术后第 1天引流量分别为(201±45)和(295±57)ml,差异均有统计学意义(χ2 =18. 69, 6. 13, 6 .08,P均<0 .001)。结论 手辅助电视胸腔镜食管癌切除术能够达到常规开胸手术相同的切除效果,且具有手术时间短、创伤小、恢复快等优点。
Objective To explore the fe as ibility and advantages of hand-assisted video-thoracoscopy for resection of es ophageal cancer. Methods Forty-five patients with esophageal cancer received hand -assisted video-thoracoscopic esophagectomy (group Ⅰ). 45 patients underwent esophagect omy through routine open thoracotomy during the same period as control(group Ⅱ) . The data of lymph node resection, operating time and blood loss were compared . Results There were no operative mortality in 2 groups. In group Ⅰ, the numb er of dissected paraesophageal lymph nodes, parahiatal lymph nodes and left gast ric nodes were(3.6±1.0), (1.3±1.1) and (4.3±1.4),respectively. While for group Ⅱ the dissected lymph nodes were (3.3±1.5) , (1.6±1.1)and (4. 7±2.1),respectively. There was no significant difference between two groups( P>0.05). However, the number of dissected mediastinal nodes was (6.6±3 .7)for group Ⅰ and (3.8±2.5) for group Ⅱ (χ~2=2.95,P<0.05). The m ean operating time was (29±5)minutes for group Ⅰ and(60±6)minutes for group Ⅱ. The mean blood loss was(93±19)ml for group Ⅰ and (145±35)ml for group Ⅱ.The mean chest tube drainage was(201±45)ml for group I and (295±57)ml for group II in the first postoperative day. The difference in above parameters bet ween 2 groups was significant (χ~2=18.69,6.13,6.08,P<0.001). Conclusions It is suggested that hand-assisted video-thoracoscopic esophagectom y is a safer, minimal invasive procedure in the resection of esophagus carcinom a.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2005年第6期351-353,共3页
Chinese Journal of Surgery
