摘要
目的探讨胸腔镜辅助下结肠代食管术在食管癌疾病的应用。方法行结肠代食管术治疗的食管癌病人100例,随机分为A组和B组。A组49例,行开胸结肠代食管术,B组51例,行胸腔镜辅助下结肠代食管术。比较两种手术方式术后吻合口瘘、肠缺血坏死、肠梗阻、呼吸功能衰竭等并发症发生率及术后死亡率。结果 B组术后感染致呼吸功能衰竭发生率为0. 02%(1/51),A组为16. 3%(8/49),两组比较差异有统计学意义(P <0. 05)。B组术后吻合口瘘发生率为3. 9%(2/51)、肠缺血坏死发生率为0. 02%(1/51)、肠梗阻发生率为0. 02%(1/51),A组分别为12. 2%(6/49)、6. 12%(3/49)和4. 1%(2/49),两组比较差异无统计学意义(P均> 0. 05),B组术后总并发症发生率为13. 7%(7/51),病死率为5. 9%(3/51),A组分别为40. 8%(20/49)和20. 4%(10/49),两组比较差异有统计学意义(P <0. 05)。结论胸腔镜辅助下结肠代食管术,可降低手术总并发症率及病死率。
Objective To investigate the application of video-assisted thoracoscopic（ VATS） esophageal replacement with colon（ ERC） for esophageal carcinoma. Methods 100 cases of esophageal carcinoma treated with surgery. The patients was randomly divided into two groups. Group A（ n = 49） underwent thoracoscopic esophageal replacement with colon. Group B（ n = 51） underwent video-assisted thoracoscopic esophageal replacement with colon. The mortality and incidence of complications such as anastomotic fistula,colonicischemia,necrosis,respiratory failure were compared. Results The incidence of respiratory failure caused by postoperative infection in group B（ 0. 02%） was lower than that in group A（ 16. 3%）（ P〈0. 05）. There was no significant difference in anastomotic fistula（ 3. 9% vs 12. 2%）,ischemic necrosis of colon（ 0. 02% vs 6. 12%） and intestinal obstruction（ 0. 02% vs 4. 1%） between group B and group A（ P〉0. 05）. The rate of postoperative complications（ 13. 7% vs 40. 8%） and mortality（ 5. 9% vs 20. 4%） between group B were lower than those in group A（ P〈0. 05）. Conclusion The total complication rate and mortality rate of esophagus replacementwith colon under thoracoscopy are significantly reduced.
作者
刘华
张军
林称意
郭家龙
刘涛
张群献
罗玲
程栋梁
王静
LIU Hua;ZHANG Jun;LIN Chenyi(Department of Cardiothoracic Surgery,Shiyan Taihe Hospital,Shiyan 442000,China)
出处
《临床外科杂志》
2018年第9期676-678,共3页
Journal of Clinical Surgery
基金
2016十堰市科学技术研究与开发项目资助计划(16Y10)
关键词
结肠代食管
电视胸腔镜手术
临床
esophageal replacement with colon
video-assisted thoracoscopic surgery
clinical
