Clinical curative effect analysis of combined thoracoscopic and laparoscopic thoracic segment esophageal carcinoma radical operation

doi:10.3877/cma.j.issn.2095-8773.2017.02.01

Abstract

Abstract:

Objective

To analyze the clinical effect of thoracic and laparoscopic combined surgery in the treatment of thoracic esophageal carcinoma.

Methods

368 cases of radical resection of thoracic esophageal cancer in Shanxi Tumor Hospital from May 2012 to August 2016 were selected. Among them, 140 cases were treated with combined thoracic and laparoscopic surgeries (observation group A), 143 cases were treated with left posterior lateral thoracic one incision surgeries (control group A) , 85 cases were treated with right posterior lateral thoracic and upper abdominal midline two incisions surgeries(control group B) . The observation group B were 82 cases treated with radical resection of thoracic middle segment in the observation group A. The differences of clinical indexes and the rate of postoperative complications were compared.

Results

The observation group A and B are less than the control group A and B on the operation time, thoracic drainage, chest tube indwelling time, postoperative hospitalization time (P<0.01); the observation group A is less than the control group A on intraoperative bleeding (P<0.01); there is no difference on intraoperative bleeding between the observation group B and the control group B (P>0.05). The observation group A is more than the control group A on the amount of left recurrent laryngeal nerve lymph node dissection (P<0.05), there is no difference on cleaning rate (P>0.05); the observation group B is better than the control group B on the amount of right recurrent laryngeal nerve lymph node dissection and cleaning rate (P<0.05). The total lymph node clearance in the observation group A and B is more than that the control group A and B (P<0.05). There is no difference between the observation group A and B and the control group A and B on the rate of postoperative cardiopulmonary and infection、anastomotic fistula, digestive system, surgical injury complications (P>0.05); the overall complication rate of the observation group A is less than the control group A (P<0.05); the overall complication rate of the observation group B has no difference with the control group B (P>0.05).

Conclusions

The combination of thoracic and laparoscopic surgery is better than two kinds of open surgeries, which is worthy of clinical promotion.

Key words: Esophageal carcinoma, Thoracoscopic, Laparoscopic, Thoracic surgery operation

Yunkui Zhang, Haitao Huang, Rongsheng Zhang, Yujie Zhang, Haitao Ma. Clinical curative effect analysis of combined thoracoscopic and laparoscopic thoracic segment esophageal carcinoma radical operation[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2017, 04(02): 71-77.

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Figures/Tables 8

References 20

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组别	总例数	年龄(岁，±s)	性别(例)		病变部位(例)		pTNM分期(例)
组别	总例数	年龄(岁，±s)	男性	女性	胸中段	胸下段	T_1-2N₀M₀	T₃N₀M₀	T_1-3N₁M₀
观察组A	140	59.2±6.2	90	50	82	58	22	45	73
对照组A	143	59.5±7.3	89	54	85	58	23	48	72
检验值	?	Z ＝－0.337	χ²＝ 0.128		χ²＝ 0.022		H ＝ 0.078
P值	?	0.736	0.721		0.882		0.787

组别	总例数	年龄(岁，±s)	性别(例)		病变部位(例)		pTNM分期(例)
组别	总例数	年龄(岁，±s)	男性	女性	胸中段	胸下段	T_1-2N₀M₀	T₃N₀M₀	T_1-3N₁M₀
观察组A	140	59.2±6.2	90	50	82	58	22	45	73
对照组A	143	59.5±7.3	89	54	85	58	23	48	72
检验值	?	Z ＝－0.337	χ²＝ 0.128		χ²＝ 0.022		H ＝ 0.078
P值	?	0.736	0.721		0.882		0.787

组别	总例数	年龄(岁，±s)	性别(例)		pTNM分期(例)
组别	总例数	年龄(岁，±s)	男性	女性	T_1-2N₀M₀	T₃N₀M₀	T_1-3N₁M₀
观察组B	82	59.2±6.3	52	30	14	27	41
对照组B	85	60.7±7.2	60	25	14	29	42
检验值	?	Z＝－1.418	χ²＝0.972		H＝0.001
P值	?	0.156	0.324		0.982

组别	总例数	年龄(岁，±s)	性别(例)		pTNM分期(例)
组别	总例数	年龄(岁，±s)	男性	女性	T_1-2N₀M₀	T₃N₀M₀	T_1-3N₁M₀
观察组B	82	59.2±6.3	52	30	14	27	41
对照组B	85	60.7±7.2	60	25	14	29	42
检验值	?	Z＝－1.418	χ²＝0.972		H＝0.001
P值	?	0.156	0.324		0.982

组别	总例数	术中出血量(ml)	手术时间(min)	胸液引流量(ml)	胸管留置时间(d)	术后住院时间(d)
观察组A	140	155.9±29.0	186.1±17.0	357.3±172.6	3.7±0.7	10.2±1.5
对照组A	143	284.0±52.4	250.0±25.3	1303.4±114.0	8.4±1.2	13.4±1.1
Z值	?	－14.399	－13.155	－14.576	－14.753	－13.553
P值	?	<0.001	<0.001	<0.001	<0.001	<0.001

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