全腔镜食管癌根治术喉返神经旁淋巴结清扫有效性及安全性分析(1)

http://www.100md.com 2019年11月15日 《健康大视野》 2019年第22期

     【摘 要】目的：研究分析全腔鏡下食管癌根治术对喉返神经旁淋巴结清扫的有效性及安全性。方法：选择2017年1月至2018年4月100例食管癌行手术治疗患者，其中50例行全腔镜下食管癌根治术(腔镜组)，另外50例行颈胸腹三切口食管癌根治术(开放组)，比较两组淋巴结清扫个数、淋巴结转移个数、双侧喉返神经旁淋巴结清扫个数、双侧喉返神经旁淋巴结转移个数;手术时间、术后前3天胸腔引流量、术后胸管留置时间、术后住院时间;并发症主要观察乳糜胸、声音嘶哑、吻合口瘘。结果：腔镜组淋巴结清扫个数、喉返神经旁淋巴结清扫个数均多于开放组(p<0.05)，两组淋巴结转移个数、双侧喉返神经旁淋巴结转移个数无明显差异(p>0.05)。腔镜组手术时间长于开放组(p<0.05)，但两组术后前3天胸腔引流量、术后胸管留置时间、术后住院时间及术后乳糜胸、声音嘶哑及吻合口瘘发生无明显差异(p>0.05)。结论：全腔镜下食管癌根治术对喉返神经旁淋巴结的清扫能达到甚至优于开放手术的效果，安全性高，不会增加患者术后并发症、术后住院时间。

    【关键词】喉返神经;淋巴结;食管癌;全腔镜手术;开放手术

    Efficacy and safety of recurrent laryngeal nerve lymph node dissection after total endoscopic radical resection of esophageal carcinoma

    Lv Xiaoxia，Zou Hui，Sun Chao，et al.Department of Thoracic surgery， Northern Jiangsu People's Hospital Yangzhou 22500，China

    Abstract：Objective To study the efficacy and safety of total endoscopic radical resection of esophageal carcinoma for recurrent laryngeal nerve lymph node dissection.Methods From January 2017 to April 2018， 100 patients with esophageal cancer were selected for surgical treatment.Among them，50 patients underwent total endoscopic radical resection of esophageal cancer(endoscopic group)and 50 patients underwent radical resection of esophageal cancer by cervical，thoracic and abdominal three-incision(open group).The number of lymph node dissection，the number of lymph node metastasis，the number of bilateral recurrent laryngeal nerve lymph node dissection and the number of bilateral recurrent laryngeal nerve lymph node metastasis were compared between the two groups.The time of operation，drainage 3 days after operation， chest tube indwelling，postoperative hospitalization，and the complications which were mainly observed chylothorax，hoarseness and anastomotic leakage were also compared.Results The number of lymph node dissection and recurrent laryngeal nerve lymph node dissection in the endoscopic group were higher than those in the open group(p<0.05).There were no significant difference in the number of lymph node metastasis and bilateral recurrent laryngeal nerve lymph node metastasis between the two groups(p>0.05).The operation time in the endoscopic group was longer than that in the open group(p<0.05)，but there were no significant difference in thoracic drainage，indwelling time of chest tube，postoperative hospitalization time，chylothorax，hoarseness and anastomotic leakage between the two groups(p>0.05).Conclusion Total endoscopic radical resection of esophageal cancer can achieve or even better than open surgery in the dissection of recurrent laryngeal nerve lymph nodes，with high safety and no increase in postoperative complications and hospitalization time.(吕小夏 邹辉 孙超 金卫国 陆世春 贺建胜 王霄霖)

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