术前口服橄榄油预防腔镜食管癌术后乳糜胸的疗效分析

Efficacy of preoperative oral olive oil in preventing chylothorax after laparoscopic esophageal cancer

目的探究术前口服橄榄油预防腔镜食管癌术后乳糜胸的应用效果。方法抽选160例2017年1月—2019年12月期间在我院胸外科进行腔镜食管癌切除术的食管癌患者为研究对象,按照1∶1的比例随机分为对照组和研究组,研究组患者手术前口服橄榄油进行胸导管标记,对照组患者未进行标记,对比2组术中胸导管暴露情况及术后乳糜胸发生率。结果研究组术中97.5%(78/80)的患者胸导管暴露,显著高于对照组的41.25%(33/80)(P<0.01)。研究组胸导管损伤患者占1.25%(1/80),对照组为7.50%(6/80),两者差异无统计学意义(P>0.05)。研究组术后乳糜胸发生率为0,显著低于对照组的7.50%(P<0.05)。研究组无病例进行二次手术结扎胸导管,而对照组有2.5%(2/80)的患者进行二次手术,但差异无统计学意义(P>0.05)。结论术前口服橄榄油能够有效提升腔镜食管癌切除术中乳糜胸的预防效果,便于手术中明确胸导管位置,提升手术安全性,降低术后并发症的发生。

Objective To investigate the effect of oral olive oil before surgery on the prevention of chylothorax after laparoscopic esophageal cancer.Methods A total of 160 esophageal cancer patients who underwent laparoscopic esophageal cancer resection in the Department of Thoracic Surgery,Fujian Provincial Hospital from January 2017 to December 2019 were selected as research subjects,and randomly divided into a control group and a study according to a one-to-one ratio.In the study group,80 patients in the study group were marked with thoracic duct by oral olive oil before surgery,and the other 80 patients in the control group were not labeled.The patients were compared with the exposure of the thoracic duct during the operation and the effect of postoperative prevention of chylothorax.Results In the study group,97.5%(78/80)patients'chest catheters were exposed during operation,which was significantly higher than 41.25%(33/80)in the control group(P<0.001).There were 1.25%(1/80)of patients with chest catheter injury in the study group and 7.50%(6/80)in the control group.There was no statistically significant difference between the two(P>0.05).The incidence of postoperative chylothorax in the study group was 0,which was significantly lower than 7.50%(6/80)in the control group(P<0.05).There were no cases in the study group who underwent a second operation for ligating the thoracic catheter,while 2.5%(2/80)of the patients in the control group underwent the second operation.There was no statistically significant difference between the two(P>0.05).Conclusion The application of oral olive oil before surgery can effectively improve the prevention effect of chylothorax during laparoscopic esophageal cancer resection,facilitate the identification of the position of thoracic duct during surgery,improve the safety of surgery,reduce the incidence of postoperative complications,and is worthy of all-round promotion and application.