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目的探究经左胸保留膈肌食管裂孔术式在食管癌手术中的应用价值。方法选择2015年3月至2016年12月郑州大学第一附属医院180例行左侧开胸食管癌手术的患者,根据手术方式不同将所有患者分为两组,每组各90例。对照组实施常规左开胸术式,试验组实施经左胸保留膈肌食管裂孔术式。记录两组术中出血量、手术时间、住院时间、淋巴结清扫数量以及术后并发症发生率。结果试验组术中出血量及住院时间均显著低于对照组,手术时间长于对照组,差异具有统计学意义(P<0.05);两组淋巴结清扫数量比较,差异无统计学意义(P>0.05);试验组中呼吸衰竭、伤口感染、颈部吻合口瘘等发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论在食管癌手术中经左胸保留膈肌食管裂孔术式能降低术中出血量,缩短治疗时间,降低并发症发生率,安全性高,值得临床推广与应用。
Objective To investigate the value of left esophageal fenestration preserved by esophagectomy in esophagectomy. Methods From March 2015 to December 2016, 180 patients with thoracic esophagectomy on the left side of the First Affiliated Hospital of Zhengzhou University were enrolled. All patients were divided into two groups according to different surgical methods, 90 cases in each group. Control group to implement the conventional left open thoracotomy, the experimental group to implement the left chest to retain the diaphragm esophageal hiatus surgery. The amount of blood loss, operation time, hospital stay, number of lymph node dissection and incidence of postoperative complications were recorded. Results The bleeding volume and length of hospital stay in the experimental group were significantly lower than those in the control group, and the operation time was longer than that in the control group (P <0.05). There was no significant difference in the number of lymph node dissection between the two groups (P> 0.05 ); The incidence of respiratory failure, wound infection, anastomotic fistula in the experimental group was significantly lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion Surgical management of esophageal cancer by left-chest resection of diaphragm esophageal hiatus can reduce intraoperative blood loss, shorten the treatment time, reduce the incidence of complications, high safety, worthy of clinical promotion and application.