[电视胸腔镜辅助食管癌切除术的安全性评估]

[Evaluation of safety of video-assisted thoracoscopic esophagectomy for esophageal carcinoma].

作者信息

Wang Hao, Tan Li-jie, Li Jing-pei, Shen Ya-xing, Zhang Yi, Feng Ming-xiang, Wang Qun

机构信息

Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Sep;15(9):926-9.

PMID:22990925

Abstract

OBJECTIVE

To explore the safety of video-assisted thoracoscopic esophagectomy for esophageal carcinoma.

METHODS

From January 2005 to March 2012, 260 patients with esophageal carcinoma received thoracoscopic esophagectomy (TE group), while 322 patients underwent conventional open esophagectomy (OE group). Operative procedures, perioperative complications, reoperation, readmission to intensive care unit (ICU), and perioperative mortality were compared between the two groups.

RESULTS

Compared with OE group, TE group possessed less thoracic operative time [(105±30) min vs. (112±41) min, P=0.000], less blood loss [(95±48) ml vs. (107±44) ml, P=0.002], shorter postoperative hospital stay [(14.3±7.5) d vs. (16.9±9.5) d, P=0.000] and more lymph node harvest from thorax [(13.5±5.0) vs. (11.6±4.7), P=0.000]. The total perioperative complication rate was lower in TE group than that of OE group (34.6% vs. 45.0%, P=0.011), as well as perioperative mortality (0.8% vs. 3.4%, P=0.032). Lower rate of readmission to ICU (5.4% vs. 10.6%, P=0.024) was found in the TE group as compared to the OE group, while the reoperation rate was comparable (1.5% vs. 2.5%, P=0.425).

CONCLUSION

Thoracoscopic esophagectomy is advantageous than open procedure in terms of surgical safety.

摘要

目的

探讨电视胸腔镜辅助食管癌切除术的安全性。

方法

2005年1月至2012年3月，260例食管癌患者接受了胸腔镜食管癌切除术（TE组），而322例患者接受了传统开放性食管癌切除术（OE组）。比较两组的手术操作、围手术期并发症、再次手术、重症监护病房（ICU）再入院情况及围手术期死亡率。

结果

与OE组相比，TE组的胸腔手术时间更短[（105±30）分钟对（112±41）分钟，P = 0.000]，失血量更少[（95±48）毫升对（107±44）毫升，P = 0.002]，术后住院时间更短[（14.3±7.5）天对（16.9±9.5）天，P = 0.000]，胸腔淋巴结清扫数量更多[（13.5±5.0）对（11.6±4.7），P = 0.000]。TE组的围手术期总并发症发生率低于OE组（34.