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Clinical analysis of surgery for type III esophageal atresia via thoracoscopy: a study of a Chinese single-center experience.

经胸腔镜手术治疗 ⅲ 型食管闭锁的临床分析: 一项中国单中心经验研究。

  • 影响因子:1.39
  • DOI:10.1186/s13019-020-01097-z
  • 作者列表:"Zhang J","Wu Q","Chen L","Wang Y","Cui X","Huang W","Zhou C
  • 发表时间:2020-03-30
Abstract

PURPOSE:The purpose of this study was to investigate the effectiveness and safety of the operation for type III esophageal atresia using a thoracoscope. METHODS:The clinical data for 92 patients with type III esophageal atresia in our hospital from January 2015 to December 2018 were analyzed retrospectively. There were 49 patients in group A who underwent thoracoscopic surgery and 43 patients in group B who underwent conventional surgery. RESULTS:The mechanical ventilation time (55.7 ± 11.4 h vs 75.6 ± 19.2 h), intensive care time (3.6 ± 1.8d vs 4.7 ± 2.0d), postoperative hospitalization time (13.1 ± 2.2d vs 16.8 ± 4.3d), thoracic drainage volume (62.7 ± 25.5 ml vs 125.4 ± 46.1 ml), blood transfusion volume (30.5 ± 10.4 ml vs 55.3 ± 22.7 ml) and surgical incision length (2.0 ± 0.5 cm vs 8.0 ± 1.8 cm) in group A were lower than those in group B, and the differences were statistically significant (P < 0.05). Among the postoperative complications, the incidences of postoperative severe pneumonia (8.2% vs 23.3%), poor wound healing (2.0% vs 14.0%) and chest wall deformity (0% vs 11.6%) in group A were significantly lower than those in group B (P < 0.05). There was no significant difference in the incidence of anastomotic stricture, tracheomalacia or gastroesophageal reflux between the two groups after surgery and early during follow-up (P > 0.05), and there were no complications such as achalasia signs and esophageal diverticulum in either group. CONCLUSION:Surgery for type III esophageal atresia via thoracoscopy has the same safety and clinical effectiveness as traditional surgery and has the advantages of smaller incision and chest wall deformity.

摘要

目的: 探讨胸腔镜手术治疗 ⅲ 型食管闭锁的有效性和安全性。 方法: 回顾性分析我院 2015年1月至 2018年12月收治的 92 例 ⅲ 型食管闭锁患者的临床资料。A 组 49 例患者行胸腔镜手术,B 组 43 例患者行常规手术。 结果: 机械通气时间 (55.7 ± 11.4 h vs 75.6 ± 19.2 h) 、重症监护时间 (3.6 ± 1.8d vs 4.7 ± 2.0d) 、术后住院时间 (13.1 ± 2.2d vs 16.8 ± 4.3d),胸腔引流量 (62.7 ± 25.5 ml vs 125.4 ± 46.1 ml),输血量 (30.5 ± 10.4 ml vs 55.3 ± 22.7 ml) 和手术切口长度 (2.0 ± 0.5 cm vs 8.0 ± 1.8 cm)A 组低于 B 组,差异有统计学意义 (p <0.05)。术后并发症中,术后重症肺炎 (8.2% vs 23.3%) 、伤口愈合不良 (2.0% vs 14.0%) 、胸壁畸形 (0% vs 11.6%) A 组明显低于 B 组 (p <0.05)。两组术后及随访早期吻合口狭窄、气管软化或胃食管反流发生率比较,差异无统计学意义 (p> 0.05)。两组均无贲门失弛缓症和食管憩室等并发症。 结论: 经胸腔镜手术治疗 ⅲ 型食管闭锁具有与传统手术相同的安全性和临床有效性,且具有切口更小、胸壁畸形等优点。

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影响因子:1.24
发表时间:2020-01-01
DOI:10.3892/etm.2019.8190
作者列表:["Shang L","Pei QS","Xu D","Liu JY","Liu J"]

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影响因子:2.64
发表时间:2020-01-01
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