摘要
目的探讨胸腹腔镜联合食管癌根治术对老年食管癌患者的近期疗效及安全性。方法依据手术方式的不同将100例老年食管癌患者分为开放组(n=41)和腔镜组(n=59),开放组患者行开放式食管癌根治术治疗,腔镜组患者行胸腹腔镜联合食管癌根治术治疗。比较两组患者的围手术期指标、并发症发生率、1年生存率、1年复发率及术后生活质量。结果腔镜组患者的术中出血量明显少于开放组,切口长度、手术时间、术后拔管时间及术后住院时间均明显短于开放组,差异均有统计学意义(P﹤0.01);两组患者的淋巴结清扫个数比较,差异无统计学意义(P﹥0.05)。腔镜组患者的并发症总发生率为10.17%,明显低于对照组的48.78%,差异有统计学意义(P﹤0.01)。腔镜组患者术后1周健康调查简表(SF-36)评分明显高于开放组(P﹤0.01)。两组患者的1年复发率和1年生存率比较,差异均无统计学意义(P﹥0.05)。结论胸腹腔镜联合食管癌根治术较开放式手术创伤小,可以减少并发症发生率,提高患者术后生活质量,但不能提高患者生存率。
Objective To study the short-term efficacy and safety of thoracoscopic and laparoscopic radical esophagectomy in the treatment of elderly patients with esophageal cancer.Method Totally,100 elderly patients with esophageal cancer were analyzed.The patients were categorized by respective surgical procedures as open surgery group(n=41)and thoracoscopic/laparoscopic surgery group(n=59).The open surgery group received open radical esophagectomy,while the thoracoscopic/laparoscopic surgery group underwent thoracoscopic and laparoscopic radical esophagectomy,the perioperative indicators,incidence of complications,1-year survival rate,1-year recurrence rate and quality of life(QOL)were evaluated and compared between the two groups.Result The intraoperative blood loss in thoracoscopic/laparoscopic surgery group was significantly less than that in open surgery group,besides,the incision length,operative time,extubation time and hospitalization time after surgery were significantly shorter compared to open surgery group(P<0.01).There was no significant difference in the number of lymph node removed between the two groups(P>0.05).The overall incidence of complications in thoracoscopic/laparoscopic surgery group was 10.17%,which was notably lower than that in open surgery group at 48.78%(P<0.01).The score of 36-item short form survey(SF-36)obtained in thoracoscopic/laparoscopic surgery group was significantly higher compared to open surgery group one week after operation(P<0.01).Similar results regarding 1-year recurrence rate and 1-year survival rate were noted for the two groups(P>0.05).Conclusion Thoracoscopic and laparoscopic radical esophagectomy is less traumatic than open surgery,thereby reducing the incidence of complications and thus improving the QOL of patients,while may not provide additional benefits to the survival rate of patients.
作者
李宏伟
赵呈华
LI Hongwei;ZHAO Chenghua(Department of Cardiothoracic Surgery,the First People’s Hospital of Xinxiang,Xinxiang 453000,He’nan,China)
出处
《癌症进展》
2020年第3期297-299,320,共4页
Oncology Progress
关键词
食管癌
老年患者
胸腹腔镜
食管癌根治术
esophageal cancer
elderly patient
thoracoscopic and laparoscopic
radical esophagectomy
