不同手术方法治疗食管癌的疗效比较及对肺功能的影响

The efficacy and lung function of different surgical methods in treatment of esophageal cancer

目的 比较胸腔镜食管癌根治术与经右胸、腹部两切口或经右胸、腹部、颈部常规三切口食管癌切除术的疗效及对肺功能的影响.方法 回顾性分析2010年1月～2013年1月在我院行手术治疗的食管癌患者60例的临床资料,其中30例食管癌患者行开胸手术,设立为对照组;其余行胸腔镜食管癌根治术患者30例,设立为观察组,比较两组的手术时间、术中出血量、术后住院时间及两组患者术前术后FEV1、FEV 1/FVC、PEF的变化、并发症发生情况.结果 观察组患者的手术时间（113.65±16.24）min、术中出血量（129.48±37.09） mL、住院时间（9.1±1.4）d,分别短于对照组或少于对照组（P＜0.05）.观察组患者的FEV1、FEV1/FVC、PEF分别较治疗前及对照组明显升高（P＜0.05）.观察组并发症发生率达13.3％,明显低于对照组（P＜0.05）.结论 胸腔镜食管癌根治术是安全可行的,它克服了传统开胸术式的缺点,具有创伤小、术中出血少、疼痛轻、并发症少等优点,且明显改善了患者的肺功能,达到根治性切除的目的.

Objective To compare the efficacy and lung function of different surgical methods in treatment of esophageal cancer. Methods A retrospective analysis of 60 cases with esophageal cancer from January 2010 to January 2013 in our hospital, 30 cases of esophageal cancer underwent thoracotomy, established as a control group, which tho- racoscopic esophageal resection in 30 patients as the establishment of the observation group. The operative time, blood loss, postoperative hospital stay and FEV1, FEV1/FVC, PEF changes before and after surgery and complications were compared. Results The patient＇s operative time were （113.65＋16.24） min, intraoperative blood loss was （129.48＋37.09） mL, hospitalization time were （9.1_＋1.4） d, respectively, shorter than the control group than the control group or between groups（P 〈 0.05）. The FEV1, FEV1/FVC, PEF of the observation group compared with before treatment and the control group was significantly higher （P 〈 0.05）. The complication rate of observation group was 13.3% ,the control group was 50.0%, the difference was statistically significant （P 〈 0.05）. Conclusion Thoracoscopic resection of esophageal cancer is safe and feasible, it overcomes the shortcomings of traditional thoracotomy style, with less trauma, less bleeding, less pain, fewer complications, and significantly improves lung function in patients and achieves the purpose of radical re- section.