Liu Bao-xing, Li Yin, Qin Jian-jun, Zhang Rui-xiang, Liu Xian-ben, Sun Hai-bo, Liu Shi-lei
Department of Thoracic Surgery, The Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2012 Sep;15(9):938-42.
To evaluate the safety and efficacy of thoraco-laparoscopic subtotal esophagectomy in the treatment of esophageal cancer.
Clinical data of 98 patients with esophageal cancer who underwent thoraco-laparoscopic subtotal esophagectomy from March 2009 to October 2011 were retrospectively analyzed. One hundred and five patients were served as controls who underwent open three-field subtotal esophagectomy in the same period.
There were significant differences between thoraco-laparoscopic and open three-field subtotal esophagectomy in blood loss [(85.1±32.8) ml vs. (215.5±60.6) ml], length of stay [(12.7±3.5) d vs. (16.9±4.5) d]), pneumonia (4.1% vs. 12.4%, P<0.05), atelectasis (3.1% vs. 10.5%, P<0.05), pleural effusion (3.1% vs. 10.5%, P<0.05), acute respiratory distress (1.0% vs. 7.6%, P<0.05) and arrhythmia (4.1% vs. 12.4%, P<0.05). No significant differences were observed in the number of lymph node harvested, operative time, anastomotic leak, thoracic abscess, chyle chest, re-laparotomy, re-thoracotomy, vocal cord paralysis, renal failure, gastric emptying, and mortality (all P>0.05).
Thoraco-laparoscopic subtotal esophagectomy is technically feasible and safe and is associated with less blood loss, less cardiopulmonary complication, and shorter hospital stay.
评估胸腹腔镜联合食管次全切除术治疗食管癌的安全性和有效性。
回顾性分析2009年3月至2011年10月期间98例行胸腹腔镜联合食管次全切除术的食管癌患者的临床资料。选取同期105例行开放三野食管次全切除术的患者作为对照。
胸腹腔镜联合食管次全切除术与开放三野食管次全切除术在失血量[(85.1±32.8)ml对(215.5±60.6)ml]、住院时间[(12.7±3.5)d对(16.9±4.5)d]、肺炎(4.1%对12.4%,P<0.05)、肺不张(3.1%对10.5%,P<0.05)、胸腔积液(3.1%对10.5%,P<0.05)、急性呼吸窘迫(1.0%对7.6%,P<0.05)及心律失常(4.1%对12.4%,P<0.05)方面存在显著差异。在清扫淋巴结数量、手术时间、吻合口漏、胸内脓肿、乳糜胸、再次开腹、再次开胸、声带麻痹、肾衰竭、胃排空及死亡率方面未观察到显著差异(均P>0.05)。
胸腹腔镜联合食管次全切除术在技术上可行且安全,具有失血量少、心肺并发症少及住院时间短的特点。