摘要
目的对比俯卧位与侧卧位微创食管切除术(minimally invasive esophagectomy,MIE)的近期疗效,探讨俯卧位MIE的可行性、安全性。方法回顾性分析2019年1月至2021年6月期间204例接受MIE治疗的食管癌患者资料,按手术体位分组并比较。结果107例俯卧位MIE(A组)与97例侧卧位MIE(B组)相比,总手术时间与胸部操作时间更短[总手术时间210 min(190,240 min)比295 min(260,325 min)、胸部操作时间(91.7±22.0)min比(119.4±24.8)min(P<0.05)],术中出血量更少[(82.1±46.3)ml比(170.9±98.1)ml(P<0.05)],术后住院时间[(12.8±4.4)d比(16.0±9.6)d]、术后经口进食时间[(8.7±2.1)d比(13.8±9.2)d]、术后拔除胸腔引流管时间[(8.7±3.3)d比(12.5±8.7)d]均更短(P<0.05);并发症发生率更低[15.0%(16/107)比34.0%(33/97)(P<0.05)],淋巴结清扫数[(23.2±7.2)枚比(22.6±5.1)枚]和术后氧饱和度(97.9%±1.6%比97.4%±3.3%)差异无统计学意义(P>0.05)。结论相较侧卧位,俯卧位MIE手术视野显露更好、手术时间更短、术中出血量更少、术后并发症发生率更低、住院时间更短,安全、可靠,短期疗效满意。
Objective To compare the short-term efficacy of minimally invasive esophagectomy(MIE)in prone position and lateral position,and explore the feasibility and safety of MIE in prone position.Methods Data of 204 patients with esophageal cancer treated with MIE from Jan.2019 to Jun.2021 were collected,grouped and compared according to surgical posture.Results The total operation time and chest operation time of 107 prone MIE(group A)were shorter than that of 97 lateral MIE(group B)[total time:210 min(190,240 min)vs 295 min(260,325 min),chest operation time(91.7±22.0)min vs(119.4±24.8)min(P<0.05)],and the intraoperative bleeding was less[(82.1±46.3)ml vs(170.9±98.1)ml(P<0.05)].Group A also had shorter postoperative hospital stay[(12.8±4.4)d vs(16.0±9.6)d],postoperative oral feeding time[(8.7±2.1)d vs(13.8±9.2)d],and postoperative thoracic drainage tube removal time[(8.7±3.3)d vs(12.5±8.7)d](P<0.05).The incidence of complications of group A was lower[15.0%(16/107)vs 34.0%(33/97)(P<0.05)],but there was no significant difference between two groups in the number of lymph node dissections[(23.2±7.2)vs(22.6±5.1)]and postoperative oxygen saturation(97.9%±1.6%vs 97.4%±3.3%)(P>0.05).Conclusions Compared with lateral position,prone position MIE showed shorter operation time,less bleeding,lower incidence of postoperative complications and shorter hospital stay,with safety,reliability and satisfactory short-term curative effect.
作者
朱天宇
李瑞欣
王国俊
Zhu Tianyu;Li Ruixin;Wang Guojun(Department of Digestive Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450001,China)
出处
《中华腔镜外科杂志（电子版）》
2022年第4期206-210,共5页
Chinese Journal of Laparoscopic Surgery(Electronic Edition)
基金
河南省科学技术厅2020河南省重点研发与推广专项(科技攻关)(202102310117)。
关键词
食管肿瘤
胸腔镜手术
食管切除术
俯卧位
侧卧位
Esophageal neoplasms
Thoracoscopic surgery
Esophagectomy
Prone position
Lateral position
