目的 探讨单操作孔全胸腔镜纵隔肿物切除手术的优势及临床价值.方法 回顾性分析2006年6月～2014年6月收治的125例行电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)切除纵隔肿物的患者,其中单操作孔VATS组56例,常规三孔VATS组69例,比较两组患者的手术时间、术中出血量、术后ICU监护治疗时间、术后胸腔引流管放置时间、术后疼痛感、术后住院时间、术后并发症等临床资料.结果 125例患者均手术顺利,无中转开胸.两组患者手术时间、术后ICU监护治疗时间、术后胸腔引流管放置时间、术后住院时间差异均无统计学意义;单操作孔VATS组术中出血量、术后疼痛评分均低于三孔VATS组,差异有统计学意义(均P＜0.05).患者无围手术期死亡,三孔VATS组出现1例肺部感染、1例心率失常,单操作孔VATS组出现1例肺部感染,余患者术后恢复顺利.随访3个月～8年,15例胸腺瘤合并重症肌无力患者(单操作孔VATS组7例,常规三孔VATS组8例)中11例患者肌无力症状术后不同程度好转(单操作孔 VATS组6例,常规三孔VATS组5例),4例患者术后肌无力症状无明显改善(单操作孔VATS组1例,常规三孔VATS组3例),15例患者术后均门诊口服溴吡啶斯的明治疗.125例患者,除常规三孔VATS组1例伤口持续性疼痛半年,给予理疗止痛等治疗好转外,其他患者均恢复良好,未见复发及其他并发症.结论 单操作孔 VATS切除纵隔肿物在技术上是安全、可行的,与常规三孔VATS相比,具有创伤小、恢复快等优点.

Objective To study the expression of survivin in Esophageal Carcinoma,and its correlation to the expression of Rb gene.Methods The immunohistochemistry was used to assay the expressionof survivin and Rb in tissues of eighty-five cases of Esophageal Carcinoma,with the normal Esophageal tissues as the control.Results The expression of Survivin and p53 protein in Esophageal Carcinoma was different with the normal esophageal tissues(P <0.01).Overexpression of survivin was strongly related to the clinical TNM stages and lymph node metatstasis(P<0.05),and the expressions of Rb was related to level of the cell differentiation and the lymph node metatstasis(P<0.05).Survivin and Rb showed no correlation(P>0.05).Conclusion The expressions of Survivin and Rb can be used as references for the prognostic of Esophageal Carcinoma.

[Objective] To study the expression of survivin in esophageal carcinoma, and its effect to the expression of p53 gene. [Methods] The immunohistochemistry was used to assay the expressionof survivin and p53 in tissues of eighty- five cases of esophageal carcinoma, with normal esophageal tissues as controls. [Results] The expression of survivin and p53 protein in esophageal carcinoma was higher than the normal esophageal tissues (P <0.01). Over expression of survivin was strongly related to the clinical TNM stages and lymph node metatstasis (P <0.05). And the expressions of survivin and p53 showed a significant correlation (P <0.05). [Conclusion] Overexpression of survivin is related to the clinical TNM stages and lymph node metatstasis, the expressions of survivin and p53 can be used as references for the diagnosis of esophageal carcinoma.