腹腔镜食管胃结合部癌根治术联合胸部小切口吻合并淋巴结清扫的临床研究

Clinical study of laparoscopic radical resection for adenocarcinoma of esophagogastric junction combined with minor thoracotomy anastomosis and lymph node dissection

摘要:

目的 探讨腹腔镜食管胃结合部癌（AEG）根治术联合胸部小切口吻合并淋巴结清扫的临床意义。方法 选取2018年6月－2019年6月咸阳市中心医院收治的AEG患者50例，随机分组为实验组（n = 25）和对照组（n = 25）。其中，实验组采用腹腔镜AEG根治术联合胸部小切口吻合并淋巴结清扫，对照组行常规腹腔镜AEG根治术并淋巴结清扫。比较两组患者手术时间、淋巴结清扫数量、术中出血量、中转开腹率、术后住院时间、术后并发症和生活质量等指标。结果 两组患者术中出血量和中转开腹率比较，差异均无统计学意义（P > 0.05）。实验组手术时间、淋巴结清扫数目、术后住院时间、术后并发症发生率和生活质量评分均优于对照组，两组比较，差异均有统计学意义（P < 0.05）。结论 应用腹腔镜AEG根治术联合胸部小切口吻合并淋巴结清扫，清扫淋巴结范围更大，并缩短手术时间和减少创伤，降低术后并发症发生率，有助于改善患者术后生存质量，值得临床推广。

Abstract:

Objective To investigate the clinical significance of laparoscopic radical resection for adenocarcinoma of esophagogastric junction (AEG) combined with minor thoracotomy anastomosis and lymph node dissection.Methods Fifty patients with cardiac cancer from June 2018 to June 2019 were selected, they were randomly divided into experimental group (n = 25) and control group (n = 25). The experimental group was treated with laparoscopic radical resection of AEG combined with minor thoracotomy anastomosis and lymph node dissection, while the control group was treated with conventional laparoscopic radical resection of AEG and lymph node dissection. The operation time, number of lymph node dissection, intraoperative blood loss, conversion rate to laparotomy, postoperative hospital stay, postoperative complications and quality of life were compared between the two groups.Results There were no significant difference in blood loss and conversion rate to laparotomy between the two groups (P > 0.05). The operation time, number of lymph node dissection, postoperative hospital stay, incidence of postoperative complications and quality of life score of the experimental group were better than those of the control group, the difference was statistically significant (P < 0.05).Conclusion The application of laparoscopic radical gastrectomy for laparoscopic radical resection of AEG combined with minor thoracotomy anastomosis and lymph node dissection can clear lymph nodes in a wider range, reduce the operation time, reduce the trauma of patients, reduce the incidence of postoperative complications, and helpful to improve the quality of life of patients after operation, which is worthy of clinical promotion.