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三维与二维辅助胸腔镜在食管癌手术中喉返神经淋巴结清扫的比较:一项回顾性研究

Comparison of three-dimensional vs. two-dimensional assisted thoracoscopy for recurrent laryngeal nerve lymph nodes dissection in esophagectomy: a retrospective study.

作者信息

Wang Qi, Ge Jintong, Wu Hua, Wu Qingquan, Zhong Sheng

机构信息

Department of Thoracic Surgery, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, 223300, Jiangsu, China.

出版信息

BMC Surg. 2024 Oct 1;24(1):278. doi: 10.1186/s12893-024-02576-z.

Abstract

BACKGROUND

This study aimed to explore the clinical value of 3D video-assisted thoracoscopic surgery in dissecting recurrent laryngeal nerve lymph nodes in patients undergoing minimally invasive esophagectomy.

METHODS

A retrospective cohort study was conducted on 205 patients, including 120 males, who underwent esophagectomy from May 2018 to May 2020 in the Department of Thoracic Surgery at the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University. Perioperative parameters, including intraoperative blood loss, operation time, the number of dissected recurrent laryngeal nerve lymph nodes, the incidence and degree of postoperative recurrent laryngeal nerve injury, the volume of postoperative thoracic drainage, and postoperative complications, were compared between the 3D and 2D groups.

RESULTS

There were no significant differences in the preoperative baseline data between these two groups (P > 0.05). The number of dissected recurrent laryngeal nerve lymph nodes in the 3D group was significantly higher than in the 2D group (P < 0.05). The operation times were significantly shorter in the 3D group than in the 2D group (P < 0.05). The volume of thoracic drainage in the first 2 days was significantly less in the 3D group than in the 2D group (P < 0.05).

CONCLUSIONS

Compared to the 2D system, the application of 3D video-assisted thoracoscopic surgery in minimally invasive esophagectomy can increase the number of dissected recurrent laryngeal nerve lymph nodes and ensure safety. Additionally, it can reduce the duration of the operation, decrease early postoperative thoracic drainage volume, and promote patient recovery.

摘要

背景

本研究旨在探讨三维视频辅助胸腔镜手术在微创食管切除术患者中解剖喉返神经淋巴结的临床价值。

方法

对205例患者进行回顾性队列研究,其中男性120例,于2018年5月至2020年5月在南京医科大学附属淮安第一人民医院胸外科接受食管切除术。比较三维组和二维组的围手术期参数,包括术中出血量、手术时间、解剖的喉返神经淋巴结数量、术后喉返神经损伤的发生率和程度、术后胸腔引流量以及术后并发症。

结果

两组术前基线数据无显著差异(P>0.05)。三维组解剖的喉返神经淋巴结数量显著高于二维组(P<0.05)。三维组的手术时间显著短于二维组(P<0.05)。三维组术后前两天的胸腔引流量显著少于二维组(P<0.05)。

结论

与二维系统相比,三维视频辅助胸腔镜手术在微创食管切除术中的应用可增加解剖的喉返神经淋巴结数量并确保安全性。此外,它可缩短手术时间,减少术后早期胸腔引流量,并促进患者康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5322/11443865/595c14d21d16/12893_2024_2576_Fig1_HTML.jpg

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