摘要
目的探讨胸、腹腔镜联合食管癌手术消化道不同重建径路术后的疗效。方法回顾性分析2007年12月～2010年12月我院125例胸、腹腔镜联合食管癌手术的临床资料,其中94例经食管床径路(食管床组)、31例经胸骨后径路(胸骨后组)重建消化道,比较2组术中、术后情况。结果 2组手术时间、淋巴结清扫数量、术中出血量、术后住院时间无明显差别(P>0.05)。2组围术期无死亡病例。食管床组术后吻合口漏发生率低于胸骨后组,但无统计学差异(4.3%vs.16.1%,χ2=3.302,P=0.069),术后第1天胃肠减压液量明显多于胸骨后组[(306.0±151.7)ml vs.(118.6±76.9)ml,t=6.591,P=0.000],术后第1天胸引流液量明显少于胸骨后组[(306.4±195.7)ml vs.(419.0±257.6)ml,t=-2.559,P=0.012]。2组术后肺部感染、心房纤颤、胸腔积液等并发症发生率无统计学差异(P>0.05)。结论胸、腹腔镜联合食管癌手术消化道不同重建径路术后疗效差异不大,应综合病人个体化选择消化道重建径路。
Objective To evaluate the postoperative outcome of the patients undergone gastric tube reconstruction via different routes after esophagectomy combined with thoracoscopy and laparoscopy for esophageal carcinoma. Methods A total of 125 patients who underwent esophagectomy with thoracoscopy and laparoseopy from December 2007 to December 2010 were analyzed retrospectively. There were 94 patients in prevertebral group and 31 in retrosternal group. Evaluation indicators included the outcome of the operation and perioperative complications. Results No significant differences was found between the two groups in operation time, number of the lymph nodes removed, intraoperative blood loss, and hospital stay （P 〉 0.05 ）. No death occurred in both the groups. Anastomotie leakage occurred more frequently in retrosternal group than that in prevertebral group, but there was no significantly different between the two groups （ 16.1% vs. 4.3% , X2 = 3. 302, P = 0. 069）. On the first day after the surgery, the amount of gastric juice of the prevertebral group was more than that in the retrosternal group [ （306.0 ± 151.7） ml vs. （ 118.6 ml ± 76.9） ml, t = 6. 591, P = 0. 000] , but the amount of pleural fluid drainage of the prevertebral group was less than that in the retrosternal group [ （306.4± 195.7） ml vs. （419.0 ± 257.6） ml, t = - 2. 559, P = 0. 012]. Perioperative complications were not significantly different between the two groups （ P 〉 0.05）. Conclusion In the esophagectomy combined with thoraeoscopy and laparoscopy for esophageal carcinoma, gastric tube reconstruction via the prevertebral and the retrosterual approaches have similar outcomes, individualized gastric tube reconstruction should be considered.
出处
《中国微创外科杂志》
CSCD
2011年第12期1082-1085,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
胸腔镜
腹腔镜
胸胃重建
Thoracoscopy
Laparoscopy
Gastric Tube Reconstruction
