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目的总结胸腔镜下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2011年9月至2013年12月行胸腔镜食管癌根治术68例患者的临床资料,其中男39例,女29例;年龄52.0~74.5岁,平均(62.0±2.5)岁。病灶位于上段10例,中段37例,下段21例。术前均行胃镜检查获取病理,68例为鳞状细胞癌。术前行胸部及上腹部增强CT及上消化道钡餐检查判断肿瘤浸润程度及与周围组织器官的关系,淋巴结转移情况,估计肿瘤切除可能性。结果本研究患者无围术期死亡,中转开胸2例。胸腔镜手术组平均淋巴结清扫个数(12.5±3.4)枚/例,胸部手术失血量(160.5±21.5)ml,术后胸管拔管时间(3.7±1.8)d,肺部并发症发生率为6.4%,总体住院时间(12.2±3.4)d。结论胸腔镜下食管癌切除术具有淋巴清扫彻底,胸部创伤小,总体并发症少,术后恢复快等优点,近期疗效满意。
Objective To summarize the clinical experience of thoracoscopic esophageal cancer radical surgery and evaluate its short-term curative effect. Methods The clinical data of 68 patients undergoing thoracoscopic esophagectomy for radical resection from September 2011 to December 2013 were retrospectively analyzed. There were 39 males and 29 females, aged from 52.0 to 74.5 years, with an average of (62.0 ± 2.5) years. The lesion was located in the upper 10 cases, the middle 37 cases, the lower 21 cases. Gastroscopy were performed preoperative pathology, 68 cases of squamous cell carcinoma. Preoperative thoracic and upper abdominal enhanced CT and upper gastrointestinal barium meal examination to determine the extent of tumor invasion and the relationship with the surrounding tissues and organs, lymph node metastasis, the possibility of tumor resection. Results In this study, there were no perioperative deaths and 2 cases were transferred to thoracotomy. The average number of lymph nodes dissection in thoracoscopic surgery group (12.5 ± 3.4) / case, blood loss in chest operation (160.5 ± 21.5) ml, postoperative chest tube extubation time (3.7 ± 1.8) d, pulmonary complication rate 6.4%, total hospital stay (12.2 ± 3.4) d. Conclusions Thoracoscopic resection of esophageal cancer has the advantages of thorough lymphadenectomy, minimal chest trauma, less overall complication and quick postoperative recovery, and the recent curative effect is satisfactory.