摘要
目的探讨胸腹腔镜和三切口手术治疗食管癌的临床疗效比较。方法选取2014年7月至2015年7月间新疆医科大学附属肿瘤医院收治的90例食管癌患者,采用随机数字表法分为胸腹腔镜组与三切口手术组,每组45例。对比两组患者手术时间、术中出血量、淋巴结清扫情况、术后胸腔引流量、术后胸管留置时间、术后监护时间、术后住院时间、住院总费用、术后30天内并发症发生率、术后1年生存率、无病生存率和生活质量。结果胸腹腔镜组手术时间、术中出血量、术后监护时间、术后住院时间、住院总费用和术后30天内并发症发生率分别为(190.45±47.83)min、(89.67±40.23)ml、(5.19±0.34)d、(16.51±3.45)d、(34193.98±450.23)元和8.0%,三切口手术组上述指标分别为(250.93±50.98)min、(224.53±80.34)ml、(7.34±1.09)d、(20.89±4.56)d、(45782.13±598.02)元和20.0%,两组比较,差异均有统计学意义(均P<0.05)。胸腹腔镜组1年生存率和无病生存率分别为84.0%和58.0%,三切口手术组上述指标分别为74.0%和42.0%,两组比较,差异均有统计学意义(均P<0.05)。胸腹腔镜组情绪健康、认知功能、社会功能、躯体功能、癌症对自身的影响、生活满足感和食欲评分分别为(93.23±11.45)分、(93.19±12.34)分、(91.23±10.39)分、(92.20±10.45)分、(93.23±10.89)分、(93.10±11.34)分和(93.90±10.98)分,三切口手术组上述指标分别为(82.67±12.81)分、(82.90±11.79)分、(82.91±10.56)分、(83.19±11.56)分、(82.56±11.19)分、(83.23±12.90)分和(83.29±11.49)分,两组比较,差异均有统计学意义(均P<0.05)。结论胸腹腔镜比三切口手术治疗食管癌的临床效果显著,康复时间短,并发症发生率低,术后1年生存率高,能改善患者生活质量。
Objective To explore and compare thoracoscopic and laparoscopic surgery and three incision surgery for esophageal cancer. Methods From July 2014 to July 2015,90 patients with esophageal cancer treated at Tumor Hospital Affiliated to Xinjiang Medical University treated were selected.Using a random number table method,patients were randomized to thoracoscopic and laparoscopic esophagectomy group and three incision esophagectomy group,with 45 patients in each group. Operation time,intraoperative blood loss,lymphnode dissection,postoperative amount of thoracic cavity drainage,postoperative time to chest tube retention,postoperative care time,postoperative length of hospital stay,the total hospitalization expenditures,the incidence of postoperative complications within30 days,postoperative survival rates,disease-free survival rate and quality of life at 1 year were compared between the two groups. Results Operation time,intraoperative blood loss,postoperative care time,postoperative length of hospital stay,the total hospitalization expenditures and the incidence of postoperative complications within 30 days were（ 190. 45 ± 47. 83） min,（ 89. 67 ± 40. 23） ml,（ 5. 19 ± 0. 34） d,（ 16. 51 ± 3. 45） d,（ 34193. 98 ± 450. 23） Yuan and 8. 0% for the thoracoscopic and laparoscopic esophagectomy group and（ 250. 93 ± 50. 98） min,（ 224. 53 ± 80. 34） ml,（ 7. 34 ±1. 09） d,（ 20. 89 ± 4. 56） d,（ 45782. 13 ± 598. 02） Yuan and 20. 0 % for the three incision esophagectomy group. Compared with three incision esophagectomy,the operation time,intraoperative blood loss,postoperative care time,postoperative hospital stay,the total hospitalization expenditures and incidence of postoperative complications within 30 days was lower in the thoracoscopic and laparoscopic esophagectomy group（ all P〈0. 05）. One year survival rate and disease-free survival rate was 84. 0 %and 58. 0 % respectively for the thoracoscopic and laparoscopic esophagectomy group which was higher than 74. 0 % and 42. 0 % o
作者
罗洞波
高云飞
吴振华
汪洋
高胜利
孙伟
LUO Dong-bo GAO Yun-fei WU Zhen-hua WANG Yang GAO Sheng-li SUN Wei(Department of Thoracic Surgery, Tumor Hospital Affiliated to Xinjiang Medical University, Urumchi 830011, China)
出处
《中国肿瘤临床与康复》
2017年第4期414-417,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
2014年新疆医科大学科研创新基金(XJC201394)
关键词
胸腹腔镜
三切口手术
食管肿瘤
Thoracoscopy/laparoscopy
Three incision surgery
Esophageal neoplasms
