胸腹腔镜食管切除术手术治疗食管癌的临床效果及对患者并发症发生的影响

Clinical effect of thoracic laparoscopic esophagectomy for esophageal cancer and its effect on patient complications

目的:探究胸腹腔镜食管切除术相较传统开放手术对食管癌患者的临床效果及对患者并发症发生的影响。方法:选取我院2015年7月-2017年11月肿瘤科收治的106例食管癌患者作为研究对象,使用随机数字表法分为传统组及胸腔镜组,每组各53例。传统组采用传统开胸手术进行治疗,胸腔镜组使用胸腹腔镜食管切除术。比较两组患者术中情况、术后疼痛程度、并发症发生率及手术前后两组肺功能指标、血清炎性因子水平。结果:术前两组肺功能指标及血清炎性因子水平无显著差异(P>0.05);胸腔镜组术中出血量、手术时间、术后引流量、VAS评分、并发症发生率及术后血清炎性因子水平显著低于传统组;肺功能相关指标显著高于传统组,差异具有统计学意义(P<0.05);两组术中淋巴结清扫个数差异不显著(P>0.05)。结论:胸腹腔镜食管切除术能有效改善食管癌患者术中指标,减低其术后并发症发生率、术后疼痛及手术对患者肺功能的影响,改善患者术后感染症状,值得临床推广。

Objective:To investigate the clinical effect of thoracoscopic and laparoscopic esophagectomy on esophageal cancer patients and patient complications compared with traditional open surgery.Methods:A total of 106 patients with esophageal cancer admitted to the department of oncology from July 2015 to November 2017 in our hospital were selected as study subjects.The patients were divided into a traditional group and a thoracoscopic group using a random number table method,with 53 cases in each group.The traditional group was treated with conventional thoracotomy and the thoracoscopic group was treated with thoracoscopic laparoscopic esophagectomy.The intraoperative conditions,postoperative pain,incidence of complications,and lung function and serum inflammatory factors were compared between the two groups before and after surgery.Results:There was no significant difference between the two groups in pulmonary function parameters and serum inflammatory factors before surgery(P>0.05);intraoperative blood loss,operation time,postoperative drainage volume,VAS score,complication rate,and postoperative thoracoscopic group serum inflammatory factors were significantly lower than the traditional group;lung function-related indicators were significantly higher than the traditional group,and the difference was statistically significant(P<0.05);the number of intraoperative lymph node dissection did not differ significantly(P>0.05).Conclusion:Thoracic and laparoscopic esophagectomy may effectively improve the intraoperative indicators for esophageal cancer patients,reduce the incidence of postoperative complications,postoperative pain and surgical impact on the patient's lung function,and improve the postoperative infection symptoms,with clinical significance in practice.