【作者】 杜贾军； 孟龙； 陈景寒； 彭忠民； 王磊； 张林； 王晓航；

【Author】 Du Jia-jun,Meng Long,Chen Jing- han,Peng Zhong-min, Wang lei, Zhang Lin,Wang Xiao-hang. Department of Thoracic Surgery,Shandong Provincial Hosppital,Jinan 250021,China

【机构】 山东省立医院胸外科；

【摘要】 目的探讨手辅助电视胸腔镜行食管癌切除术的可行性及优缺点。方法施行手辅助电视胸腔镜食管癌切除术45例(研究组),同期施行常规开胸手术45例(对照组)。比较两组患者术中淋巴结清扫情况和两组患者围术期情况。结果研究组与手术组比较,手术效果满意。研究组和对照组的食管旁淋巴结分别为(3．55±1．01)、(3．31±1．52)枚,贲门旁淋巴结分别为(1．27± 1．07)、(1．59±1．09)枚,胃左动脉周围淋巴结分别为(4．27±1．42)、(4．68±2．10)枚,清扫均没有显著差异(P>0．05),隆突下淋巴结清扫分别为(6．64±3．72),(3．82±2．48)枚,研究组好于对照组 (P<0．05)。手术时间分别为(28．68±4．90),(59．73±6．06)min,胸部失血量分别为(92．72±18． 56),(145．01±35．42)ml,术后第一天引流量分别为(201．36±44．65),(295．45±57．22)ml均有显著差异(P<0．001)。结论手辅助电视胸腔镜食管癌切除术能够达到常规开胸手术相同的切除效果,且具有手术时间短、创伤小、恢复快等优点。更多还原

【Abstract】 Objective:To explore the feasibility and advantage of Hand-Video -Assisted sur-gery(HVATS) for esophageal cancer. Methods: 45 cases received Hand-video-assisted surgery (test group), During the same period ,45 cases underwent routine open thoracotomies(control group). Comparing the data of lymph node resection and operating time、blood loss. Result There were no operative mortality in two groups. The number of periesophageal dissected nodes was(3. 55±1. 01)for test group and (3. 31±1. 52) for control group(p>0. 05). The number of parahiatal dissected nodes was (1. 27±1. 07) for test group and (1. 59±1. 09) for control group (p>0. 05). The number of left gastric dissected nodes was (4. 27±1. 42) for test group and (4. 68±2. 10) for control group(p>0. 05). The number of mediastinal dissected nodes was (6. 64±3. 72)for test group and (3. 82±2. 48) for control group(p<0. 05). The mean thoracic operating time was (28. 68±4. 90)min for test group and(59. 73±6. 06)min for control group. The mean thoracic operating blood loss was(92. 72±18. 56)rnl for test group and (145. 01±35. 42)ml for control group. The mean chest tube drainage was(201. 36 44. 65)ml for test group and (295. 45 57. 22)ml for control group in the first day after operation. The difference in above parameters between two groups was significant (all p <0. 001). Conclusion: It is suggested that HVATS is a safer ,less traumat ,even better procedure in the treatment of esophagus carcinoma than routine open thra-cotomy.更多还原