摘要
目的 探讨胸腹腔镜联合术式与开放术式行二野淋巴结清扫对食管癌手术切除患者近远期临床疗效及并发症的影响.方法 选取行食管癌切除二野淋巴结清扫患者150例,采用随机数字表法分为对照组（75例）和观察组（75例）,分别采用开放术式和胸腹腔镜联合术式治疗,比较两组患者手术时间、术中出血量、住院时间、淋巴清扫数目,再次手术率,转送ICU率及术后并发症发生情况等.结果 两组患者手术时间比较差异无统计学意义（P＞0.05）;观察组患者术中出血量和住院时间均显著优于对照组,差异有统计学意义（P＜0.05）;观察组患者淋巴清扫数目显著多于对照组,差异有统计学意义（p＜0.05）;两组患者再次手术率和转送ICU率比较差异无统计学意义（P＞0.05）;两组患者术后声音嘶哑和吻合口狭窄发生率比较差异无统计学意义（P＞0.05）;观察组患者术后肺部感染和心律失常发生率显著低于对照组,差异有统计学意义（P＜0.05）.结论 胸腹腔镜联合术式行食管癌切除二野淋巴结清扫可有效减少术中创伤,加快术后康复进程,提高淋巴清扫效果,并降低术后并发症发生风险,疗效优于开放术式.
Objective To investigate the short-term and long-term clinical efficacy and complication of different types of lymph node radical resection in the surgery for esophageal cancer patient. Methods 150 esophageal cancer patients with surgical resection were chosen and randomly divided into two groups including control group （ 75 patients ） with open surgical method and observation group （ 75 patients ） with thoracolaparoscopic esophagectomy surgical method; and the operation time, bleeding amount, hospital staying time, number of lymph node resection, reoperation rate, ICU transferring rate and postoperative complication occurrence of both groups were compared. Results There was no significant difference in operation time between 2 groups （ P〉0.05 ） . The bleeding amount, hospital staying time of observation group were statistically significant better than control group （ P〈0.05 ） . The number of lymph node dissection of observation group were significantly better than control group （ P〈0.05 ） . There was no significant difference in reoperation rate and ICU transferring rate between 2 groups （ P〉0.05 ） . There was no significant difference in incidence of hoarseness and anastomotic stenosis between 2 groups （ P〉0.05 ） . The incidence of pulmonary infection and arrhythmia of observation group were significantly better than control group （ P〈0.05 ） . Conclusion Compared with open surgical method, thoracolaparoscopic esophagectomy surgical method with two-field lymph node dissection for esophageal carcinoma surgical method can effectively reduce the degree of operative trauma, accelerate postoperative rehabilitation process, improve the effects oflymph node dissection, and reduce postoperative complication risk.
出处
《浙江临床医学》
2015年第10期1701-1702,1710,共3页
Zhejiang Clinical Medical Journal
关键词
胸腔镜
腹腔镜
开放
食管癌
二野淋巴结清扫
Thoracoscopy
Laparoscopy
Open
Esophageal cancer
Two-field lymph node dissection
