【摘要】 目的分析并比较胸腔镜与常规开胸三切口治疗食管癌的效果。方法选取2007年1月—2014年6月常州市武进人民医院胸外科行手术治疗的食管癌127例,按手术方式分为开胸手术组(58例)和胸腔镜手术组(69例)。比较2组手术时间、术中出血量、术后引流量、术后恢复速度、并发症发生率及3年预后的差异。结果胸腔镜组手术用时长于开胸手术组,但术中出血量和术后第1 d引流量少于开胸手术组(P<0.05);2组术中淋巴结清除量比较差异无统计学意义(P>0.05)。胸腔镜组术后拔除引流管时间和术后出院均早于开胸手术组(P<0.05)。2组术后ICU转入率和病死率比较差异无统计学意义(P>0.05)。胸腔镜组呼吸系统并发症发生率及并发症总发生率均少于开胸手术组(P<0.05)。2组术后1、3年生存率、复发率及远处转移率比较差异均无统计学意义(P>0.05)。结论胸腔镜和常规开放手术比较并不能明显提高患者生存率,但胸腔镜可减少术中损伤,促进恢复,降低患者呼吸系统并发症。更多还原

【Abstract】 Objective To analyze and compare effect between thoracoscopy and conventional three-incisions thoracotomy in treatment of patients with esophageal cancer. Methods A total of 127 esophageal cancer patients with surgical treatment admitted during January 2007 and June 2014 were divided into thoracotomy group( n = 58) and thoracoscopy group( n = 69) according to surgical methods. Operative time,intraoperative bleeding volume,postoperative draining volume,postoperative recovery speed,incidence rate of complications and prognosis within 3 years were compared between two groups. Results In thoracoscopy group,operative time was longer,while intraoperative bleeding volume and draining volume at 1 std after surgery were less than those in thoracotomy group( P < 0. 05). There was no significant difference in intraoperative clearance volume of lymph nodes between two groups( P > 0. 05). Postoperative extraction of drainage tube and time of discharge times in thoracoscopy group were earlier than those in thoracotomy group( P <0. 05). There were no significant differences in ICU transferring rate and fatality rate between two groups( P > 0. 05).Incidence rates of respiratory complications and the total incidence of complications in thoracoscopy group were less than those in thoracotomy group( P < 0. 05). There were no significant differences in survival,recurrence and distant metastasis rates in 1 year and 3 years after surgery between two groups( P > 0. 05). Conclusion Thoracoscopy can not significantly increase survival rate of patients compared with that by conventional open surgery,but it may reduce intraoperative injuries,accelerate recovery and reduce incidence rate of respiratory complications.更多还原