摘要
目的分析改良的喉返神经淋巴结清扫方式在胸腔镜食管手术中的应用价值。方法全腔镜食管癌病人188例,传统组48例,采用先游离食管后清扫喉返神经淋巴结;改良组140例,采用先清扫喉返神经淋巴结后游离食管,比较喉返神经链旁淋巴结清扫技术改良前后的手术相关指标,术后病理以及术后并发症情况。结果改良组和传统组手术操作时间分别为(460.2±66.4)min、(438.9±75.5)min,平均清扫淋巴结枚数分别为(18.9±2.6)枚和(19.7±2.2)枚、术后喉返神经损伤发生率分别为22.9%和10.7%,吻合口瘘并发症发生率分别为12.5%和4.3%,两组比较差异均有统计学意义(P<0.05)。结论先清扫喉返神经淋巴结后游离食管这种改良的喉返神经淋巴结清扫方式在胸腔镜食管手术中较传统方式具有一定的优势。
Objective To analysis the evaluation of the modified recurrent laryngeal nerve lymph node dissection in thoracoscopic surgery for esophageal cancer. Methods The clinical data of 188 patients with total endoscopic esophageal cancer were collected,48 of which were traditional groups and 140 were modified. analysis and comparison were made on the surgical indicators,postoperative pathology and postoperative complications before and after the improvement of recurrent laryngeal nerve chain lymph node dissection. Results There was no statistically significant difference between the two groups in general clinical data,postoperative pathology and postoperative complications. The operation time in modified group[（ 460. 2 ± 66. 4） min] was increased compared with the traditional group [（ 438. 9 ± 75. 5） min,P = 0. 032） ]. However,the modified group had an advantage over the traditional group in the average number of lymph node dissection[（ 18. 9 ± 2. 6） vs（ 19. 7 ± 2. 2）,P = 0. 029）,the incidence of recurrent laryngeal nerve injury（ 22. 9% vs 10. 7%,P = 0. 035）,and the incidence of complications of anastomotic fistula（ 12. 5% vs 4. 3%,P = 0. 045）（ P〈0. 05）. Conclusion The modified surgical procedure performed firstly with the laryngeal nerve lymph node dissection and esophagus dissection,which is superior to the traditional method in thoracoscopic surgery for esophageal cancer. Tt is worth promoting.
作者
吴骁伟
张霓
王麒
付向宁
WU Xiaowei;ZHANG Ni;WANG Qi;et al.(Department of Thoracic Surgery, TongJi Hospital, TongJi Medical College, Huazhong university of Science and Technolo- gy, Wuhan 430030, Chin)
出处
《临床外科杂志》
2018年第6期430-433,共4页
Journal of Clinical Surgery
关键词
食管癌
胸腔镜手术
喉返神经
esophageal cancer
thoracoscopicsurgery
recurrent laryngeal nerve
