Objective To explore the minimal invasiveness and practability of combined video-assisted thoracic surgery (VATS) with two trocars and endoscopic ultrasonography (EUS) in the treatment of esophageal leiomyoma. Methods Between February 2007 and February 2012, we retrospectively analysed the clinical data of 166 patients who underwent various surgeries for the treatment of esophageal leiomyoma. Among them, 62 received routine thoracotomy (group A), 49 accepted conventional VATS surgery with three trocars (group B), and 55 underwent combined VATS surgery with two trocars and EUS (group C). Then, we summarized the clinical indexes of patients in all the three groups for further comparative analysis. Results There was no significant difference among the three groups in age, gender, and lesion location, origin level and size (P > 0.05). There were significant differences between group A and C in blood loss, surgery time, intraoperative localization, postoperative incision pain, hospitalization expenses, length of hospital stay, fasting time, pulmonary infection, and the complications during the follow-up (P < 0.05). There were significant differences between group C and B in blood loss, surgery time, intraoperative localization, fasting time and pulmonary infection (P < 0.05). Conclusion Combined VATS surgery with two trocars and EUS is safe, minimally invasive, thorough with few complications, which is worthy of clinical promotion.
目的 探討腹腔鏡闌尾切除術的臨床經驗和應用價值。方法 回顧性分析腹腔鏡二孔法闌尾切除術 39例(二孔法組)和三孔法闌尾切除術70例(三孔法組)的臨床資料。結果 順利完成手術107例； 中轉開腹2例,其中闌尾嚴重粘連1例,腹膜后闌尾1例。術后發生粘連性腸梗阻1例,經保守治療痊愈出院。住院時間2~9 d,平均3 d。隨訪全部患者2~24個月,平均12個月,未發生其他并發癥。結論 腹腔鏡闌尾切除術具有創傷少、并發癥發生率低及恢復快的優點,將成為闌尾切除術的首選術式。腹腔鏡二孔法闌尾切除術操作簡單,易于推廣; 三孔法則具有處理復雜闌尾切除術的優勢。