The Clinical Analysis On The Radical Correction Of Esophageal Carcinoma Via VATS (Video-assisted Thoracoscopic Surgery)

Objectives:This dissertation explores the short-term curative effect on radical correction of esophageal carcinoma via VATS(video-assisted thoracoscopic surgery)by comparing the effects of radical correction of esophageal carcinoma via VATS and the routine radical correction of esophageal carcinoma via chest opening.Clinical Data and Methods:The study is based on the review and analysis of the clinical data of 10 cases of esophageal carcinoma patients who received VATS radical correction in Guangxi Tumour Hospital from January 2004 to November 2006.The 10 cases include 3 cases of PT₂N₀M₀,5 cases of PT₃N₀M₀ and 2 cases of PT₃N₁M₀,of which one on the epimere in chest,seven on the midpiece in chest and two on the hypomere in chest.The surgical operation involved VATS oesophagus separation at the thoracic segments with combination of esophageal carcinoma removal via abdominal incision and neck incision,oesophagus and stomach cervix inosculation and regional lymphaden cleaning.All these cases received cervical esophagus and stomach end-to-side anastomosis,compared with the short-term curative effect of 37 cases ofâ…¡-stage andâ…¢-stage esophageal carcinoma patients who received the routine radical correction of esophageal carcinoma via chest opening,of which 26 with an incision on the left chest and the left neck respectively and 11 with an incision on the right chest,the right neck and the right upper belly respectively.These 37 cases included 7 with PT₂N₀M₀,2 with PT₂N₁M₀,21 with PT₃N₀M₀,7 with PT₃N₁M₀,among them seven are on the epimere in chest,twenty-seven are on the midpiece in chest and seven are on the hypomere in chest.Results:The VATS group and the routine group are of similar age and proportion of sex,and are of the similar results of the functions of the main body organs examined before the operations.The differences between the two groups are of no statistical significance(P＞0.05).But notable differences are identified in post-operation oxygen intake time,post-operation pain,anhelation and arhythmia(P＜0.05).Compared with the routine group,the VATS group needs shorter time for oxygen intake and has less pain and lower incidence rate of anhelation and arhythmia after the operation.No obvious differences are found between the two groups in the operation time,blood loss,the number of the mediastinal lymph node cleaning and the length of the upper and lower incisal edge of the specimens(P＞0.05).Neither are significant differences seen in the duration of the chest tube in the body,chest drainage and the ecchymoma of the incision,the stoma narrowing,the stoma fistula,the injury of laryngeal nerve, and other complications(P＞0.05).Six months of following-up after the operation revealed that there was one case of stoma narrowing in the VATS group,one case of death due to tumor recurrence and transfer after 6 months of post-operation and two cases of stoma narrowing in the routine group.Conclusion:The radical correction of esophageal carcinoma via VATS(video-assisted thoracoscopic surgery)demonstrates better short-term curative effects.It has the advantages of small incision and reduced risk of chest damage;it minimizes the chances of anhelation and arhythmia;it reduces the patients' post operation pain and the hours needed for oxygen intake.Therefore,it is well worth developing and promoting.