新型超声刀在食管癌根治术中的应用观察

目的探讨新型超声刀在食管癌根治术中的应用价值。方法以应用超声刀行食管癌根治术45例为观察组（A组），其中常规开胸（A1组）34例，胸腔镜辅助（A2组）11例；同期应用电刀行食管癌根治术44例为对照组（B组），其中常规开胸（B1组）34例，胸腔镜辅助（B2组）10例，比较各组手术时间、术中出血量、术后胸腔引流量、淋巴结清扫等情况。结果A1，A2组分别与B1，R2组相比较，其手术时间明显缩短[Al、A2组分别为（100±17）rain、（90±14）min，B1、B2组分别为（125±22）min、（120±17）min]，术后胸腔引流量明显减少[A1、A2组分别为（550±33）ml、（380±40）ml，B1、B2组分别为（920±59）ml、（500±57）m1]，（P〈0．01），且A2组术中出血量较B2组减少[（107±20）mlVS（135±24）m1]，（P〈0．05）。结论超声刀应用于食管癌根治术具有操作精确，止血彻底，减少创伤，缩短手术时间及提高手术安全性等优点，在胸腔镜辅助术式中优势更为明显，值得推广。

New type ultracision-harmonic scalpel for radical resection of esophageal carcinoma

Objective To investigate the clinic application of new type ultracision harmonic scalpel in radi-cal resection of esophageal carcinoma. Methods Ninety-nine patients were divide into 2 groups. Group A had 45 patients given radical resection of esophageal carcinoma with new type ultracision harmonic scalpel. Among them 34 cases had conventional procedure resection (Group A1), 11 cases had VAMT resection (Group A2). Group B included 44 patients receiving resection of esophageal carcinoma using electrotome, among them 34 cases with conventional procedure(Group B1) and 10 cases had VAMT resection(Group B2). The bleeding volume, operation time, first 72 hours drainage volume after operation and lymph node retrieval number were compared among Group A1 and B1, A2 and B2. Results Operation time and 1 st 72-hour drainage volume decreased significantly in A1 and A2 groups, compared with B1 and B2 groups individually(P <0.01). The A2 group also had less bleeding volume than B2 group(P < 0.05). There was no difference of number of resection lymph node among Group A1 and B1; A2 and B2. Conclusion Radical resection of esophageal carcinoma with new type ultracision harmonic scalpel showes advantages of precise incision, littel hemorrhage and damnification, shortened operation time and good safety, especially in the resection carcinoma of the esophagus by VAMT.