早期拔除胸腔引流管在VATS食管癌切除术中的应用

目的:探讨早期拔除胸腔引流管在电视胸腔镜下（VATS）食管癌切除术促进术后康复中应用的可行性。方法:100例行电视胸腔镜下食管癌切除术病人，随机分为ERAS组和对照组，每组50例。ERAS组采取术后早期拔除胸管，对照组采用传统方式拔管。对比观察两组病人拔管时间、拔管前总引流量、胸腔积液发生率、胸腔穿刺率、住院时间、治疗费用的差异。结果:ERAS组拔管时间早于对照组，差异有统计学意义（P＜0.05）；ERAS组总引流量少于对照组，差异有统计学意义（P＜0.05）；两组病人胸腔积液发生率无显著差异（P＞0.05）；胸腔穿刺率无显著差异（P＞0.05）；ERAS组住院时间及治疗费用均低于对照组，差异有统计学意义（P＜0.05）。结论:早期拔除胸腔引流管在电视胸腔镜下食管癌切除术术后中的应用是安全可行的，并且恢复更快，住院费用更少。

Application of early removal of the chest tube in postoperative period of the video-assisted thoracoscopic esophagogastrectomy

Objective:To investigate the feasibility of early removal of the chest tube in postoperative period of the video-assisted thoracoscopic esophagogastrectomy.Methods:A total of 100 patients undergoing video-assisted thoracoscopic esophagogastrectomy were randomly divided into two groups:The ERAS group and the control group.The ERAS group was treated with early removal of the chest tube after surgery,and the control group was treated with traditional way.The results of the time of removal of the chest tube,the amount of drainage,the incidence of pleural effusion and thoracentesis,the length of hospital stay and the cost of hospitalization in the two groups were observed.Results:The time of removal of the chest tube in the ERAS group was earlier than the one in the control group,and there was a statistical significant difference（P＜0.05）.The amount of drainage in the ERAS group was less than the one in the control group,and there was a statistical significant difference（P＜0.05）.However,there was no statistical significant difference in the incidences of pleural effusion and thoracentesis between the two groups（P＞0.05）.The duration of hospital stay and the cost of hospitalization in the ERAS group were significantly lower than those in the control group（P＜0.05）.Conclusion:The application of early removal of the chest tube after video-assisted thoracoscopic esophagogastrectomy was safe and feasible,and it made patients recover faster and pay less for hospitalization.