电视胸腔镜3D与2D模式下食管癌胸部手术的比较

发布时间：2018-05-17 17:05

本文选题：食管癌 + 电视胸腔镜手术　；参考：《中国微创外科杂志》2017年02期

【摘要】：目的探讨电视胸腔镜3D模式与2D模式食管癌胸部手术的优缺点。方法 2013年7月~2015年5月我科53例食管癌采用3D-VATS(3D组),51例采用2D-VATS(2D组),比较手术时间、出血量、淋巴结清扫数目、术后24 h引流量、总引流量、胸腔闭式引流管带管时间及术后并发症发生情况。结果 104食管癌均在胸腔镜下完成胸部手术。3D组手术时间(63.4±3.3)min,明显短于2D组(71.7±5.1)min(t=-9.891,P=0.000);出血量(53.1±5.5)ml,明显少于2D组(66.9±9.4)ml(t=-9.180,P=0.000);淋巴结清扫数目(14.8±2.9)枚,明显多于2D组(13.1±2.0)枚(t=3.467,P=0.000)。3D组术后24 h引流量(196.2±34.2)ml,与2D组(205.0±32.4)ml差异无统计学意义(t=-1.346,P=0.181);总引流量(579.2±59.4)ml,与2D组(599.8±56.5)ml差异无统计学意义(t=-1.811,P=0.073);胸腔闭式引流管带管时间(4.7±0.6)d,与2D组(5.1±1.4)d差异无统计学意义(t=-1.906,P=0.059);2组术后心率失常、肺部感染、吻合口漏、喉返神经损伤发生率无统计学差异(P0.05)。2组1年生存率无统计学差异(log-rankχ~2=0.435,P=0.510)。结论电视胸腔镜3D模式下食管癌胸部手在手术时间、出血量、淋巴结清扫数目较2D模式下有一定的优势,在24 h引流量、总引流量、胸腔带管时间和术后并发症上无明显差异。
[Abstract]:Objective to investigate the advantages and disadvantages of 3 D and 2 D mode thoracic surgery for esophageal carcinoma. Methods from July 2013 to May 2015, 53 cases of esophageal carcinoma in our department were treated with 3D-VATS(3D group. 51 cases were treated with 2D-VATS(2D group. The operation time, the amount of bleeding, the number of lymph node dissection, the drainage flow at 24 hours after operation and the total drainage volume were compared. Time and complications of thoracic closed drainage tube. Results all patients with esophageal carcinoma underwent thoracic surgery under thoracoscopy. The operative time was 63.4 卤3.3 min, which was significantly shorter than that in 2D group (71.7 卤5.1 min) -9.891U 0.000g, and the amount of bleeding was 53.1 卤5.5 ml, which was significantly less than that in 2D group (66.9 卤9.4 ml -9.180 min), and the number of lymph node dissection was 14.8 卤2.9%. It was significantly more than 2D group (13.1 卤2.0). There was no significant difference between 2D group and 2D group in the drainage flow rate (196.2 卤34.2 32.4)ml) at 24 hours after operation, the total drainage volume was 579.2 卤59.4ml, there was no statistical difference between 2D group and 2D group (599.8 卤599.8 卤56.5)ml); there was no statistical difference between 2D group and 2D group (4.7 卤0.6d). There was no statistical difference between 2D group and 2D group (599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤599.8 卤1.811P0.073). After operation, the heart rate was abnormal in the two groups. There was no significant difference in the incidence of pulmonary infection, anastomotic leakage and recurrent laryngeal nerve injury. Conclusion the operation time, bleeding volume and the number of lymph node dissection in the thoracic hand of esophageal carcinoma under 3D video-assisted thoracoscopy are superior to that in 2D mode, and the total drainage is 24 h. There was no significant difference in the time of thoracic canal and postoperative complications.
【作者单位】：厦门大学附属第一医院胸外科;厦门大学附属第一医院手术室;

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