侧俯卧位与侧卧位胸腔镜食管癌根治术的临床对照研究

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。

Clinical comparative analysis of thoracscopic esophagectomy in left lateral and forward position or lateral position

Objective:To investigate the safety,feasibility and recent clinical efficacy of thoracscopic esophagecto-my in left lateral and forward position or lateral position. Methods:From March 2013 to October 2015,82 patients un-derwent thoracoscopic esophagectomy in left lateral and forward inclination position(40)or lateral position(42). Pa-tients had a left lateral position and 45o forward inclination after anesthesia. Thoracic esophagus dissociation and lymph nodes dissection were finished with totally thoracoscopic surgery. Results:The operative time in left lateral and forward 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,postop-erative chest drainage time(5. 05 ± 1. 69)days,postoperative hospital stay(12. 73 ± 5. 01)days,incidence of postop-erative complications(5 / 40,12. 5% ),and in the lateral position group blood loss(131. 67 ± 56. 22)ml,postoperativechest 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). Con-clusion:Thoracoscopic esophagectomy in left lateral and forward inclination position is safe,minimally invasive,feasi-ble,and to some extent,it can shorten the operation time.