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胸腔镜辅助与纵隔镜辅助食管癌切除术的疗效的病例对照研究。

A Case-Control Study on the Therapeutic Effect of Mediastinoscope-Assisted and Thoracoscope-Assisted Esophagectomy.

机构信息

105002Graduate School of Ningxia Medical University, Ningxia, China.

Department of Nuclear Medicine, 74747The General Hospital of Ningxia Medical University, Ningxia, China.

出版信息

Surg Innov. 2021 Jun;28(3):316-322. doi: 10.1177/1553350620958265. Epub 2020 Sep 10.

Abstract

To compare the clinical efficacies of mediastinoscope-assisted and thoracoscope-assisted esophagectomy. Seventy-six patients with esophageal cancer who underwent minimally invasive esophagectomy at the General Hospital of Ningxia Medical University between June 2015 and January 2019 were retrospectively evaluated. Among them, 28 patients underwent mediastinoscope-assisted transhiatal esophagectomy (MATHE), and 48 received thoracoscope-assisted transthoracic esophagectomy (TATTE). The perioperative clinical data and follow-up data of the 2 groups were compared. All operations were successful in both groups. MATHE was favorable in terms of operation time, intraoperative blood loss, drainage volume 3 days after surgery, postoperative hospital stay, and hypoproteinemia ( < .05). Lymph node dissections were less than those in the TATTE ( < .05). No significant differences in long-term postoperative complications and survival rate were found between the 2 groups ( > .05). MATHE has the advantages of minimal trauma, shorter operation time, less intraoperative blood loss, and faster recovery. More adequate tumor clearance in terms of lymph node dissection can be achieved with TATTE. However, the comparison of survival rates between the 2 groups is similar.

摘要

比较胸腔镜辅助与纵隔镜辅助食管切除术的临床疗效。回顾性分析 2015 年 6 月至 2019 年 1 月宁夏医科大学总医院收治的 76 例微创食管癌患者的临床资料,其中 28 例行纵隔镜辅助经颈胸腹三切口食管切除术(MATHE),48 例行胸腔镜辅助经胸食管切除术(TATTE)。比较两组患者围手术期临床资料及随访资料。两组患者均顺利完成手术。MATHE 组在手术时间、术中出血量、术后 3 天引流量、术后住院时间、低蛋白血症方面优于 TATTE 组( <.05)。淋巴结清扫数量少于 TATTE 组( <.05)。两组患者术后长期并发症发生率和生存率比较差异无统计学意义( >.05)。MATHE 具有创伤小、手术时间短、术中出血量少、恢复快的优点。TATTE 可获得更充分的淋巴结清扫以达到肿瘤清除效果。但是两组患者的生存率比较无差异。

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