胸腔镜下小切口食管癌根治术的近期疗效观察

目的总结胸腔镜下小切口食管癌根治术的临床经验，评价其近期疗效。方法回顾性分析60例食管癌患者的资料，根据其治疗方式随机分为观察组及对照组，每组30例。观察组采用电视辅助胸腔镜手术（video—assisted thoracoscopic surgery，VATS）行食管癌切除术，对照组采用常规开胸三切口食管癌根治术，对2组患者手术时间、术中出血量、淋巴结清扫个数、术后引流量、术后并发症、肺功能指标进行评价。结果观察组手术时间短，术中出血量及术后引流量少，术后并发症发生率低，与对照组患者比较差异有统计学意义（P〈0．01）；观察组患者肺功能各指标改善均优于对照组（P〈0．05）。2组患者术中淋巴结清扫个数比较差异无统计学意义（P〉0．05）。结论VATS小切口食管癌根治术具有创伤小、并发症少、淋巴结清扫彻底等优点，对呼吸功能影响较小，值得在临床上推广。

Observation on short term therapeutic effects of thoracoscopic - assisted small incision Ivor- Lewis esophagectomy

Objectives To review the clinical experiences of thoracoscopic - assisted small incision Ivor - Lewis esophagectomy and evaluate its short term therapeutic effects. Methods The clinical data of 60 cases of esophageal carcinoma were analyzed retrospectively. All the cases were assigned into observation group and control group according to different surgical procedures （n = 30 each）. Video -assisted thoraeoscopic surgery （VATS） was applied to Ivor- Lewis esophagectomy in observation group and routine three incision open chest Ivor - Lewis esophagectomy was applied in con- trol group. The time of operation, bleeding volume during operation, number of lymph nodes dissected, postoperative drainage volume, postoperative complications, and postoperative lung function were evaluated between the two groups. Results The time of operation, bleeding volume during operation, postoperative drainage volume, postoperative compli- cations in observation group were significantly shorter or lower than those in control group （P 〈 0.01 ）. The postoperative lung function indexes in observation group were significantly improved than those in control group （P 〈 0.05 ）. There was no significant difference in the number of lymph nodes dissected between the two groups （P 〉 0.05 ）. Conclusions VATS small incision Ivor - Lewis esophagectomy has potential to be widely applied in clinical treatment of esophageal car- cinoma for limited trauma, fewer complications, better lymph nodes dissection and little influence on respiratory system function.