[1]李宗荣,李柏钧,卢昌超,等.单操作孔胸腔镜联合腹腔镜在McKeown食管癌根治术中的应用评估[J].第三军医大学学报,2017,39(18):1854-1858.
 LI Zongrong,LI Bojun,LU Changchao,et al.Evaluation of single-utility incision thoracoscopy combined with laparoscopy in radical McKeown esophagectomy for esophageal cancer[J].J Third Mil Med Univ,2017,39(18):1854-1858.
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单操作孔胸腔镜联合腹腔镜在McKeown食管癌根治术中的应用评估(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
39卷
期数:
2017年第18期
页码:
1854-1858
栏目:
临床医学
出版日期:
2017-09-30

文章信息/Info

Title:
Evaluation of single-utility incision thoracoscopy combined with laparoscopy in radical McKeown esophagectomy for esophageal cancer
作者:
李宗荣李柏钧卢昌超周一凡钟永泷罗金龙
广西壮族自治区人民医院心胸外科
Author(s):
LI Zongrong LI Bojun LU Changchao ZHOU Yifan ZHONG Yonglong LUO Jinlong

Department of Thoracic and Cardiovascular Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, 530021, China

关键词:
食管癌单操作孔胸腔镜McKeown食管癌根治术
Keywords:
esophageal cancer single-utility incision video-assisted thoracoscopy McKeown esophagectomy
分类号:
R615; R730.56; R735.1
文献标志码:
A
摘要:

目的    评估单操作孔胸腔镜联合腹腔镜在McKeown食管癌根治术中的安全性及可行性。方法    分析广西壮族自治区人民医院心胸外科2015年1月至2016年1月40例接受McKeown食管癌根治术的中下段食管癌患者资料,其中11例行单操作孔胸腔镜联合腹腔镜McKeown食管癌根治术(single-utility incision total endoscopy McKeown esophagectomy,sTEME),29例行三孔胸腔镜腹部开放McKeown食管癌根治术(three-port thoracoscope combined with laparotomy McKeown esophagectomy,tTLME),比较两组的术中情况、手术结果及术后并发症的发生率。结果    两组在胸部手术时间、胸部术中出血量及胸部淋巴结清扫数量方面差异无统计学意义(P>0.05);sTEME组的腹部手术时间较tTLME组长(P<0.05),腹部术中出血量、术后24 h疼痛指数评分及术后住院时间优于tTLME组(P<0.05)。两组腹部淋巴结清扫数、术后重症监护时间、术后并发症发生率及术后6个月淋巴结复发转移情况差异无统计学意义(P>0.05)。结论    单操作孔胸腔镜联合腹腔镜McKeown术治疗中下段食管癌可行,虽然会延长手术时间,但手术创伤小、住院时间短、近期效果满意。

Abstract:

Objective     To evaluate the safety and the feasibility of single-utility incision thoracoscopy combined with laparoscopy in radical McKeown esophagectomy (sTLME) for esophageal cancer. Methods    Clinical data of 40 patients with esophageal carcinoma undergoing minimally invasive esophagectomy in our department from January 2015 to January 2016 were collected and retrospectively analyzed. Among the 40 patients, 11 patients underwent sTLME, and the other 29 subjects were treated with three-port thoracoscopy combined with laparotomy McKeown esophagectomy (tTLME). The patient’s surgery situations, operative outcomes, and postoperative complications were compared between the 2 groups. Results      There were no significant differences in thoracic operative time, blood loss and number of lymph node dissection between the sTLME and tTLME groups (P>0.05). But the sTEM group though had a longer abdominal operative time (P<0.05), it had less blood loss, lower postoperative pain index and shorter length of hospital stay (P<0.05). However, no significant differences were observed in number of abdominal lymph node dissection, post-operative duration for intensive care, occurrence of post-operative complications, and recurrence and metastasis in lymph node within 6 months between the 2 groups (P>0.05). Conclusions    TLME is feasible for middle and lower esophageal cancer. Although it will extend the operation time, but has less surgical trauma, shorter hospital stay and satisfactory short-term outcomes.

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更新日期/Last Update: 2017-09-29