胸腹腔镜联合食管癌切除术与传统开胸食管癌切除术术后并发症的比较

Comparisons of postoperative complications of thoracoscopic surgery combined with laparoscopic surgery and traditional thoracotomy for esophageal cancer

目的比较胸腔镜联合腹腔镜食管癌切除术与传统开胸术的术后并发症发生情况。方法选取2015年10月至2017年10月于大同市五医院手术治疗的胸中段食管癌患者112例,按照随机数字表法将其分为两组:试验组56例行胸腔镜联合腹腔镜切除术,对照组56例行传统开胸手术。观察两组患者支气管镜吸痰频率、术后胸腔引流量和手术并发症情况,分析患者术后症状恢复和并发症改善的情况。结果试验组胸腔引流量低于对照组,差异有统计学意义(P<0.05)。试验组住院天数和抗生素应用时间少于对照组,差异有统计学意义(P<0.05)。试验组气管切开率低于对照组,差异有统计学意义(P<0.05)。试验组支气管吸痰次数少于对照组,差异有统计学意义(P<0.05)。结论胸腔镜联合腹腔镜食管癌切除术术后肺部感染率下降,胸腔引流量降低,支气管镜吸痰及气管切开频率和抗生素应用时间减少,术后恢复顺利,围术期内无重大并发症,具有一定的安全性和可靠性。

Objective To compare the postoperative complications of laparoscopic esophagectomy combined with laparoscopic esophagectomy and conventional thoracotomy. Methods A total of 112 patients with esophageal cancer of the thorax and esophagus admitted to the Fifth Hospital of Datong from October 2015 to October 2017 were selected and randomly divided into two groups according to the random number table method. Fify-six cases in the experimental group underwent thoracoscopy combined with abdominal cavity, and 56 cases in the control group underwent conventional thoracotomy. The frequency of suctioning bronchoscopy, postoperative chest drainage and complications were observed. The postoperative recovery of symptoms and the improvement of complications were analyzed. Results The thoracic drainage volume of the experimental group was lower than that of the control group (P<0.05). The hospitalization days and antibiotic application time of the experimental group were less than those of the control group, and the difference was significant (P<0.05). The tracheotomy rate of the experimental group was lower than that of the control group (P<0.05). The number of bronchial sputum aspiration in the experimental group was less than that in the control group (P<0.05). Conclusions The incidence of pulmonary infection and thoracic drainage decreases after thoracoscopic and laparoscopic esophagectomy for esophageal cancer, the frequency of sputum aspiration and tracheotomy by bronchoscope and the time of antibiotic application decreases, and the recovery is smooth. There is no major complication during the perioperative period, so these method has certain security and reliability.