胸腔镜腹腔镜联合食管癌切除术疗效分析.docVIP

胸腔镜腹腔镜联合食管癌切除术疗效分析 　　[摘要] 目的 对比分析胸腹腔镜联合食管癌切除术与三切口食管癌切除术的临床效果。 方法 整群选取2013年1月―2014年12月该院收治的食管癌患者128 例，根据术式将患者分为常规三切口组（56 例）和胸腹腔镜联合组（72 例），常规三切口组患者给予常规三切口食管癌切除手术，胸腹腔镜联合组患者进行胸腔镜联合腹腔镜下食管癌切除术。 结果 常规三切口组患者手术时间，术中出血量，术后引流总量，疼痛评分高于胸腹腔镜联合组，且差异有统计学意义（P0.05），住院费用胸腹腔镜联合组较高，且差异有统计学意义（P0.05）。 结论 胸腹腔镜联合食管癌切除术效果优于传统三切口食管癌切除术，但费用较高。 　　[关键词] 食管癌；传统手术；胸腔镜；腹腔镜 　　[中图分类号] R735 [文献标识码] A [文章编号] 1674-0742（2015）08（b）-0080-02 　　[Abstract] Objective To compare the efficacy between thoracoscopic and laparoscopic esophagectomy and three-incision esophagectomy for esophageal carcinoma. Methods 128 patients with esophageal carcinoma admitted to our hospital between January 2013 and December 2014 were assigned， according to operation modes， to conventional three-incision group in which the 56 patients were given three-incision esophagectomy， and thoracoscopy and laparoscopy group in which thoracoscopic and laparoscopic esophagectomy was performed for the 72 patients. Results The operation duration， intraoperative blood loss， postoperative drainage volume and pain scores were longer or higher in the conventional three-incision group than in the thoracoscopy and laparoscopy group， and the difference were statistically significant（P0.05）； the hospitalization expenses in the thoracoscopy and laparoscopy group was higher than that in the conventional three-incision group， and the difference was statistically significant（P0.05）. Conclusion Compared with three-incision esophagectomy， thoracoscopic and laparoscopic esophagectomy for esophageal carcinoma can provide better efficacy but higher hospitalization expenses. 　　[Key words] Esophageal cancer； Traditional surgery； VATS； Laparoscopy 　　食管癌为常见消化道恶性肿瘤，手术治疗是食管癌的主要治疗方法之一[1]。有研究表明清扫腹腔、胸腔、颈部三野淋巴结可提高食管癌术后远期生存率[2]。开放手术为食管癌切除术传统方法，因为创伤大、并发症多、术后患者生活质量差等不良后果逐渐被微创手术所代替[3]。该院自2008年3月开展胸腔镜食管癌根治术，2010年5月起逐步开展胸腔镜腹腔镜联合食管癌切除术，至2013年1月技术逐渐成熟。该研究通过对该院2013年1月―2014年12月期间进行的72例胸腹腔镜联合食管癌切除术与56例三切口食管癌切除术的临床效果进行分析，以比较两种方法的临床效果，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　对2013年1