胸腹腔镜与开胸食管癌根治术对患者肺功能影响及临床疗效的对照研究

Comparative study on the lung function and effect of thoracoscopic laparoscopy and thoracotomy for radical resection of esophageal cancer

目的比较胸腹腔镜与开胸行食管癌根治术后对患者肺功能影响及临床疗效。方法回顾性分析2016年1月至2018年10月该院收治的270例胸腹腔镜(微创组)与开胸食管癌根治术(开胸组)患者的临床资料,比较两组术后患者的肺功能及临床疗效。结果微创组术后用力肺活量占预计值百分比(FVC%)、1 s用力呼气量与FVC比值(FEV1/FVC)、动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)、术中出血量、术后胸腔24 h引流量、留置胸管时间、监护及住院时间、并发症发生率明显优于开胸组,但住院总费用高于开胸组,差异有统计学意义(P<0.05);两组手术时间及淋巴结清扫情况比较,差异无统计学意义(P>0.05)。结论胸腹腔镜食管癌根治术对患者肺功能影响小,临床疗效良好。

Objective To compare the effect of thoracoscopic laparoscopy and thoracotomy for radical resection of esophageal cancer on pulmonary function and clinical efficacy.Methods Clinical data of 270 esophageal cancer patients in hospital were retrospectively analyzed from January 2016 to October 2018,they were divided into the minimally invasive group and the thoracotomy group.The lung function and clinical efficacy of the two groups were compared.Results Compared with the thoracotomy group,forced vital capacity as a percentage of predicted value(FVC%),1 second forced expiratory volume and FVC ratio(FEV1/FVC),arterial partial pressure of oxygen(PaO2),arterial oxygen saturation(SaO2),the intraoperative blood loss,postoperative drainage flow of thoracic cavity 24 h after surgery,indwelling thoracic tube,monitoring time,hospitalization time and complication incidence rate after surgery in the minimally invasive group were better,while the total hospitalization cost was higher,the differences were statistically significant(P<0.05),but there was no significant difference in operation time and lymph node dissection between the two groups(P>0.05).Conclusion Thoracoscopic laparoscopy for radical esophageal cancer has little effect on lung function and good clinical efficacy.