腔镜下食管癌根治术治疗高龄食管癌效果分析

Efficacy evaluation of esophageal cancer resection under an endoscope for aged patients

目的探讨腔镜下食管癌根治术治疗高龄食管癌患者的临床疗效及对近期肺功能的影响。方法将100例70-80岁高龄食管癌患者分为两组,腔镜组（48例）采用胸腹腔镜联合下食管癌根治术,对照组（52例）采用传统的开放食管癌根治术,比较两组患者手术时间、术中失血量、术后住院时间、淋巴结清扫数目、术后拔管时间,检测术后1月血气分析指标的变化。结果腔镜组手术时间、淋巴结清扫数目均多于对照组（P〈0.05）,术中出血量、术后住院时间、术后拔管时间均少于对照组（P〈0.05）,两组患者术后Pa O2均有下降（P〈0.05）,但腔镜组下降幅度小于对照组（P〈0.05）。结论胸腹腔镜下食管癌根治术治疗高龄食管癌患者具有术中出血少、住院时间减少、术后恢复快、近期对肺功能影响小等优点,值得临床推广。

Objective To investigate the clinical efficacy of esophageal cancer radical surgery under endoscope in aged patients and the effect on early pulmonary function. Methods One hundred aged patients （70 to 80 years old）with esophageal cancer were divided into VATS and control groups. The VATS group （ n = 48） was treated with laparoscope combined with thoracic esophageal cancer radical prostatectomy. The control group （n = 52）was treated with conventional thoracic surgery. The operative time, content of bleeding, hospitalization, number of lymph node cleaning, extubated time and changes in preoperative blood gas analysis after one month of operation were compared between the two groups. Results Although the operative time and the number of lymph node cleaning in the VATS group was more than that in the control group （P 〈 0.05 ）, the content of bleeding, the hospitalization and the extubated time in the VATS group were significantly less than that in the control group （P 〈 0. 05）. The PaO2 level was decreased after operation in the both groups （P 〈 0. 05）. There was no significant difference in the preoperative blood gas analysis between the two groups （ P 〉 0. 05）, but the decent degree of PaO2 level in the VATS group was less than that in the control group （P 〈 0. 05 ）. Conclusion Thoracoscopic esophageal surgery for aged patients with esophageal cancer has advantages of less blood loss, shorter hospitalization, quicker recovery and less effect on early pulmonary function. It＇s worthy for promotion.