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目的探讨电视胸腔镜下行食管癌手术胸部淋巴结清扫的临床效果。方法 60例食管癌患者,依据患者入院顺序分为乙组(35例)和甲组(25例)。甲组患者通过电视胸腔镜下行食管癌手术进行治疗,而乙组患者通过常规开胸手术进行治疗,对比两组患者的临床及淋巴结清扫情况。结果甲组患者的术中失血量为(121.25±15.47)ml,乙组为(280.41±20.58)ml,对比差异具有统计学意义(P<0.05)。甲组患者术后的引流量为(280.17±34.45)ml,乙组为(352.47±46.84)ml,对比差异具有统计学意义(P<0.05)。甲组患者的住院时间为(9.51±1.34)d,乙组为(15.38±2.46)d,对比差异具有统计学意义(P<0.05)。甲组患者的治疗费用为(44521.25±332.47)元,乙组为(92046.28±517.57)元,对比差异具有统计学意义(P<0.05)。甲组患者气管旁、食管旁、支气管旁、下肺静脉旁以及隆突旁等部位的淋巴结清扫情况优于乙组患者(P<0.05)。结论电视胸腔镜下行食管癌手术胸部淋巴结清扫的临床应用效果很好,有效减少患者的术中出血量和术后引流量,并缩短患者的住院时间和降低治疗费用,且淋巴结清扫情况很好,值得推广。
Objective To discuss the clinical effect of video-assisted thoracoscopic esophagectomy on thoracic lymph node dissection. Methods Sixty patients with esophageal cancer were divided into group B (35 cases) and group A (25 cases) according to the order of admission. Patients in group A underwent esophagectomy via video-assisted thoracoscopic surgery, while patients in group B underwent conventional thoracotomy. The clinical and lymph node dissections were compared between the two groups. Results The intraoperative blood loss in group A was (121.25 ± 15.47) ml and in group B was (280.41 ± 20.58) ml, the difference was statistically significant (P <0.05). The drainage volume of group A was (280.17 ± 34.45) ml and group B was (352.47 ± 46.84) ml, the difference was statistically significant (P <0.05). The length of hospital stay in group A was (9.51 ± 1.34) days and in group B (15.38 ± 2.46) days, the difference was statistically significant (P <0.05). The cost of treatment in group A was (44521.25 ± 332.47) yuan and in group B was (92046.28 ± 517.57) yuan, the difference was statistically significant (P <0.05). Patients in group A had better lymph node dissection than those in group B (P <0.05) in para-trachea, paraesophageal, para-bronchial, para-pulmonary veins and para-protuberances. Conclusion The clinical application of video-assisted thoracoscopic esophagectomy for the removal of thoracic lymph nodes in esophageal cancer is very effective, which can effectively reduce the intraoperative blood loss and postoperative drainage volume, shorten the hospitalization time and reduce the cost of treatment, and the lymph node dissection is very good, Worth promoting.