Short-term outcomes of single lumen endotracheal tube and double lumen endotracheal
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摘要:
目的比较单腔气管插管和双腔气管插管在微创食管癌根治术中近期效果的差异。 方法回顾性分析福建省立医院胸外科2014年1月~2015年12月接受微创Mckeown术的94例食管癌患者的临床资料。 结果单腔插管组术中出血显著少于双腔插管组（205.6±62.1 mL vs 277.9±219.9 mL，P=0.028），左喉返神经旁淋巴结清扫数（3.4±5.5 vs 1.2±2.5，P=0.043）和纵隔淋巴结清扫数（19.1±14.2 vs 13.7±9.2，P=0.037）显著多于双腔插管组。两组手术时间、右喉返神经旁淋巴结清扫数、淋巴结清扫总数、平均住院时间、平均住ICU时间及术后并发症的发生率的差异无统计学意义。 结论单腔气管插管具有费用低、操作简单、术野显露好的特点，有助于纵隔淋巴结的清扫和减少术中出血，其近期效果优于双腔支气管插管。 Abstract:ObjectiveTo compare the short-term outcomes between single lumen endotracheal tube anesthesia (SLET) anddouble lumen endotracheal tube anesthesia (DLET) in minimally invasive esophagectomy. MethodsClinical data of 94 patients who received minimally invasive Mckeown esophagectomy for esophageal cancer form January 2014 to December 2015 were retrospectively analyzed. ResultsThere was less operation bleeding (205.6±62.1 mL vs 277.9±219.9 mL, P=0.028) more left laryngeal recurrent nerve chain lymph nodes (3.4±5.5 vs 1.2±2.5, P=0.043) and mediastinal lymph nodes (19.1±14.2 vs 13.7±9.2, P=0.037) harvested in SLET group compared to DLET group. There was no significant difference in operative duration, number of total dissected lymph nodes and right laryngeal recurrent nerve chain lymph nodes, mean duration of hospitalization, mean duration of ICU stay and operative complications. ConclusionThe short-term outcomes are better in SLET than in DLET group because of its lower cost, easy to use and good exposure of operation field. It facilitates mediastinal lymphadenctomy and reducing bleeding. -
表 1 单腔插管组和双腔插管组围手术期指标对比
变量 单腔插管组(n=42) 双腔插管组(n=52) P 手术时间（min） 283.8±66.5 299.7±76.7 0.335 胸腔镜手术时间（min） 102.2±31.2 112.4±37.2 0.18 术中出血（mL） 205.6±62.1 277.9±219.9 0.028 淋巴结清扫总数（枚） 30.1±19.6 24.4±11.7 0.101 纵隔淋巴结清扫数（枚） 19.1±14.2 13.7±9.2 0.037 左喉返神经旁淋巴结清扫数（枚） 3.4±5.5 1.2±2.5 0.043 右喉返神经旁淋巴结清扫数（枚） 2.5±2.3 2.1±2.6 0.456 平均住院时间（d） 18.7±11.2 22.9±17.0 0.171 平均住ICU时间（d） 0.5±2.2 2.3±7.4 0.129 
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表 2 单腔插管组和双腔插管组手术后并发症对比（例, %）
变量 单腔插管组(42例) 双腔插管组(52例) P 肺部感染 10 (23.8%) 12 (23.1%) 0.934 呼吸衰竭 2 (4.8%) 6 (11.5%) 0.291 吻合口瘘 3 (7.1%) 6 (11.5%) 0.727 喉返神经损伤 2 (4.8%) 3 (5.8%) 1 1 围手术期死亡 0 (0%) 1 (1.9%) 4
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