目的:探讨侧俯卧位及侧卧位胸腔镜食管癌根治术的安全性、可行性及近期临床疗效。方法:选择我院2013年3月至2015年10月施行侧俯卧位胸腔镜食管癌根治术40例(试验组)与同期施行侧卧位食管癌根治术42例(对照组),比较两组患者临床疗效。结果:侧俯卧位胸腔镜组手术时间(5.10±0.74)h显著短于侧卧位胸腔镜组(5.76±0.96)h(P=0.001);侧俯卧位胸腔镜组术中出血量(125.75±44.94)ml、术后胸腔引流时间(5.05±1.69)天、术后住院时间(12.73±5.01)天、术后并发症发生率12.5%(5/40),比侧卧位组术中出血量(131.67±56.22)ml、术后胸腔引流时间(4.90±1.53)天、术后住院时间(11.95±4.17)天、术后并发症发生率11.9%(5/42),差异无统计学意义(P〉0.05)。结论:侧俯卧位胸腔镜食管切除术在技术上是安全、微创、可行的,在一定程度上可以缩短手术时间。
Objective:To investigate the safety, feasibility and recent clinical efficacy of thoracscopic esophagectomy in left lateral and forweard position or lateral position. Methods:From March 2013 to October 2015,82 patients underwent thoracoscopic esophagectomy in left lateral and forweard inclination position (40) or lateral position (42). Patients had a left lateral position and 45° forweard inclination after anesthesia. Thoracic esophagus dissociation and lymph nodes dissection were finished with totally thoracoscopic surgery. Results:The operative time in left lateral and forweard position thoracoscopy group (5.10 ±0.74) h was significantly shorter than in the lateral position thoracoscopy group (5.76 ± 0.96) h ( P = 0. 001 ). Blood loss in left lateral and forward position was ( 125.75 ±44.94) ml, postoperative chest drainage time (5.05 ± 1.69) days, postoperative hospital stay ( 12.73 ±5.01 ) days, incidence of postoperative complications (5/40,12.5%) ,and in the lateral position group blood loss ( 131.67 ±56.22) ml, postoperative chest drainage time(4.90 ±1.53 ) days, postoperative hospital stay ( 11.95 ±4.17 ) days, incidence of postoperative complications (5/42,11.9% ) ,and other aspects of the differences were not statistically significant (P 〉 0.05 ). Conclusion:Thoracoscopic esophagectomy in left lateral and forward inclination position is safe, minimally invasive, feasible, and to some extent, it can shorten the operation time.