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食管癌三种不同手术路径的临床效果比较 预览

Comparison of Clinical Effects of Three Different Surgical Approaches for Esophageal Cancer
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摘要 目的 比较食管癌常规三种手术路径优缺点,合理选择手术路径。方法 回顾性分析我院2012年10月—2014年10月收治的135例接受不同手术路径治疗(左胸45例、右胸50例、微创腔镜路径40例)食管癌患者的临床资料。结果 左胸组患者的手术时间为(183.8±38.5)min短于右胸组的(269.5±62.9)min及微创腔镜组的(272.3±52.6)min,差异均具有统计学意义(P〈0.05);右胸组清扫淋巴结(23.7±5.1)枚多于左胸组的(15.9±4.7)枚,差异具有统计学意义(P〈0.05);微创腔镜组术中出血量(88.1±41.2)ml、术后3天总胸腔引流量(562.1±69.7)ml、住院时间(11.9±3.7)天低于左胸组(233.3±95.1)ml、(712.5±69.8)ml、(13.7±6.1)天,右胸组的(245.7±78.5)ml、(832.9±132.6)ml、(16.5±6.2)天,差异均具有统计学意义(P〈0.05);右胸组患者的并发症发生率为30.0%高于左胸组的22.2%及微创腔镜组的10.00%,差异均具有统计学意义(P〈0.05)。结论 不同手术路径治疗食管癌切除术效果以及术后并发症的发生不同,应根据手术前综合性评估,选择利于肿瘤及淋巴结完整切除,减少围手术期并发症的发生,改善预后的手术路径。 Objective To compare the advantages and disadvantages of three conventional surgical approaches for esophageal cancer and to select the proper surgical approach. Methods The clinical data of 135 cases of esophageal carcinoma treated with different surgical approaches from October 2012 to October 2014 were analyzed retrospectively. Results The operation time of the left chest group (183.8±38.5) min was shorter than that of the right chest group (269.5±62.9) min and the minimally invasive endoscopic group (272.3±2.6) min, the difference was statistically significant (P〈0.05). The lymph nodes in the right chest group (23.7±5.1) were more than those in the left thoracic group(15.9±4.7), the difference was statistically significant (P〈0.05). Minimally invasive endoscopic group the amount of bleeding (88.1~41.2) ml, 3 days after surgery, the total pleural drainage (562.1~69.7) ml, hospitalization time (11.9~3.7) days, which were lower than the left breast group(233.3~95.1)ml, (712.5~69.8)ml, (13.7±6.1) days, the right thoracic group (245.7±78.5)ml, (832.9±132.6) ml(16.5±6.2) days, the difference was statistically significant (P〈0.05). The complications of the right thoracic approach group were 30.0% higher than those in the left thoracic group and 22.2% in the minimally invasive endoscopic group 10.0%, the difference was statistically significant (P〈0.05). Conclusion Clinical effect of different surgical approaches for treatment of esophageal carcinoma resection and postoperative complications, should be evaluated according to the preoperative comprehensive selection for tumor and lymph node resection, reduce per;operative complications, improve the prognosis of surgical path.
作者 颜嵩 YAN Song( Department of Thoracic Surgery, The People's Hospital of Sheyang County, Sheyang Jiangsu 224300, China)
出处 《中国继续医学教育》 2017年第19期138-140,共3页 China Continuing Medical Education
关键词 食管癌 手术路径 效果 比较 esophageal carcinoma operative pathway effect comparison
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