摘要
目的探讨全胸腔镜手术(VATS)下食管癌根治术治疗中、上段I、Ⅱ期食管癌与传统食管癌根治术的疗效。方法选择2009年2月至2011年11月接受食管癌根治术治疗的中、上段Ⅰ、Ⅱ期食管癌患者52例,按照随机数字表法分为两组,每组26例。观察组行VATS下食管癌根治术,对照组行传统食管癌根治术。对比两组术前、术中、术后近期情况。结果观察组胸部手术时间[(116±41)min]、胸部出血量[(125±35)m1]、术后第1天胸腔引流量[(335±175)m1]、术后胸导管保留时间[(7.0±2.5)d]、术后总引流量[(1290±525)m1]、术后36hVAS评分[(3.2±1.3)分]、术后72h右上肢功能恢复[(5.0±2.6)cm]与对照组[分别为(154±25)min、(295±105)ml、(490±105)ml、(10.8±2.2)d、(1785±749)ml、(7.5±1.2)分、(14.3±2.1)cm]比较差异有统计学意义(P〈0.01或〈0.05)。两组淋巴结清扫个数、住院时间、住院总费用比较差异无统计学意义(P〉0.05)。结论VATS与开胸食管癌根治术在治疗中、上段Ⅰ、Ⅱ期食管癌具有相似的完全性和彻底性,但VATS较开胸手术的术中胸部出血量少,术后胸腔引流量少,术后患者疼痛轻微,上肢活动恢复好。
Objective To compare the therapeutic effects between video-assisted thoracic surgery (VATS) and thoractomy for radical operation in patients with stage Ⅰ-Ⅱ esophageal cancer. Methods Retrospectively reviewed 52 patients with stage Ⅰ-Ⅱ esophageal cancer, underwent either VATS radical operation( VATS group, n = 26) or standard radical operation via thoractomy (open group, n = 26) form February 2009 to November 2011. Patients' operative characteristics and postoperative courses were comparable between the two groups. Results The operative time was (116 ± 41 )rain in the VATS group and( 154 ± 25 )rain in the open group (P 〈 0.05 ) ;In the two groups, the number of mediastinal tymphonode resection was( 12. 0 ± 8.0) and( 17.2 ±2.6) (P 〉 0. 05 ), blood loss was( 125 _ 35 ) ml and(295 ± 105 ) ml, the amount of thoracic cavity drainage after operation was ( 1290 ± 525 ) ml and (490 ± 105 ) ml, the time of postoperative chest tube was (7.0 ± 2.5 ) d and ( 10. 8 - 2. 2 ) d ( P 〈 0. 05 ), the postoperative 36 h pain(VAS) score was(3.2 ± 1.3) and(7.5 ± 1.2) (P 〈 0.01 ), the postoperative locomotor activity of fight upper extremity was ( 5.0 ± 2.6 ) em and ( 14.3 ± 2. 1 ) em( P 〈 0.01 ). Conclusions Compared with thoractomy ,VATS thoracic surgery for patients with stage Ⅰ-Ⅱesopha- geal cancer appears to be as effective but less morbid.
出处
《中国实用医刊》
2012年第23期6-8,共3页
Chinese Journal of Practical Medicine
关键词
食管癌
胸腔镜手术
疗效
肿瘤分期
Esophageal carcinoma
Video-assisted thoracic surgery
Therapeutic effects
Neo- plasm staging