食管癌腹腔镜游离胃与开腹游离胃的围手术期效果比较

摘要

Objective To compare peri-operational outcomes between laparoscopic and traditional approach for esophageal cancer surgical treatment.Methods 78 cases of esophageal cancer patients in Affiliated Tumor Hospital of Xinjiang Medical University between Janurary 2012 to June 2014 were divided into two different groups.There were 41 cases in laparoscopic group and 37 cases in another traditional group.Items compared between these two different groups were operational duration,volume of blood losing,number of lymph node dissected,post-operational days of ICU staying,post-operational days of hospital staying, post-operative infectious incidence rate and incidence rate of anastomosis leakage.Results The volume of blood losing in laparoscopic group and traditional group were (244.03 ± 44.33 )mL and (322.50 ± 51.55)mL respectively,there was significant differences between two roups (t = 6.296,P =0.000).The incidence rate of lung infection in laparoscopic group and traditional group were 10.8%(4/37)and 31.7%(13/41),respectively,with significant differences (χ2 =4.983,P =0.026).The incidence rate of opera-tional region infection in laparoscopic group and traditional group were 5.4%(2/37)and 22.0%(9/41)re-spectively,with significant differences (χ2 =4.395,P =0.036).The post-operational days of ICU staying and hospital staying in laparoscopic group and traditional group were (1.58±1.53)d ,(15.69±4.73)d and (2.57±1.70)d,(18.38±6.50)d,respectively,with significant differences (t =2.842,2.183,P =0.006, 0.032).Conclusion The outcome in laparoscopic group is better than that in traditional group,patients in laparoscopic group may get an earlier discharge from hospital and less infectious complications than those in traditional group.%目的：对比开胸联合腹腔镜手术与传统开放手术2种术式治疗食管癌的围手术期效果。方法选择2012年1月－2014年6月在新疆医科大学附属肿瘤医院胸外科接受手术治疗的食管癌患者78例，其中传统开放手术41例，开胸联合腹腔镜手术37例，比较2种手术方式的手术操作时间、术中失血量、淋巴结清扫个数、术后ICU 留观时间、术后住院天数、术后感染发生率以及术后吻合口瘘发生率方面的差异。结果开胸联合腹腔镜组术中出血量为（244．03±44．33）mL，传统开放组为（322．50±51．55）mL，两组比较差异有统计学意义（t ＝6．296，P＝0．000）；开胸联合腹腔镜组术后肺部感染发生率为10．8％（4／37），传统开放组为31．7％（13／41），两组比较差异有统计学意义（χ2＝4．983，P ＝0．026）；开胸联合腹腔镜组术后术区感染发生率为5．4％（2／37），传统开放组为22．0％（9／41），两组比较差异有统计学意义（χ2＝4．395，P ＝0．036）；开胸联合腹腔镜组术后 ICU 留观时间为（1．58±1．53）d，传统开放组为（2．57±1．70）d，两组比较差异有统计学意义（t ＝2．842，P ＝0．006）；开胸联合腹腔镜组术后住院天数为（15．69±4．73）d，传统开放组为（18．38±6．50）d，两 组 比 较 差 异有统计学意义（t ＝2．183，P ＝0．032）。结论开胸联合腹腔镜手术较传统开放手术对于食管癌患者具有更好的围手术期临床效果，术后恢复期更短，术后感染并发症更少。