食管癌患者胸腔镜手术后并发难治性狭窄的影响因素

Influencing Factors of Refractory Stenosis in Patients with Esophageal Cancer afterThoracoscopic Surgery

目的探讨食管癌患者胸腔镜手术后并发难治性狭窄发生的影响因素。方法选取80例接受胸腔镜手术治疗的食管癌患者,并依据术后3个月内有无并发难治性狭窄分为发生组和未发生组,将全部可能的因素纳入,经单因素与多因素分析找出食管癌患者胸腔镜手术后并发难治性狭窄的影响因素。结果80例接受胸腔镜手术治疗的食管癌患者中有19例术后并发难治性狭窄,发生率为23.75%。初步比较2组的基线资料后,将比较差异有统计学意义的变量纳入作为自变量行单因素分析,后将全部资料纳入建立多元回归模型行多因素分析,结果显示,糖尿病史、肿瘤浸润程度(M3-SM1)、固有肌层损伤、持续性低氧血症均是食管癌胸腔镜手术后并发难治性狭窄的影响因素(OR>1,P<0.05)。结论糖尿病史、肿瘤浸润程度(M3-SM1)、固有肌层损伤、持续性低氧血症均可能增加食管癌患者胸腔镜手术后并发难治性狭窄风险,对伴有上述风险因素食管癌患者的早期针对性合理干预,可能对降低术后难治性狭窄发生率、改善患者预后有积极意义。

Objective To investigate the influencing factors of refractory stenosis in patients with esophageal cancer after thoracoscopic surgery.Methods 80 patients with esophageal cancer who received thoracoscopic surgery for treatment were selected.They were divided into an occurrence group and a non-occurrence group according to whether there was complicated refractory stenosis within 3 months after operation.All possible factors were included,and the influencing factors of refractory stenosis in patients with esophageal cancer after thoracoscopic surgery were found through univariate and multivariate analysis.Results Among the 80 patients with esophageal cancer who received thoracoscopic surgery for treatment,19 patients had postoperative refractory stenosis,and the incidence was 23.75%;after initially comparing the baseline data of the 2 groups,the variables with statistically significant differences in the comparison were included and used as independent variables,and a single factor analysis was performed,then all the data were included,a multiple regression model was established and a multivariate analysis was performed,the results showed that history of diabetes mellitus,degree of tumor infiltration(M3-SM1),inherent muscular layer injury,and persistent hypoxemia were all influencing factors for refractory stenosis after thoracoscopic surgery for esophageal cancer(OR>1,P<0.05).Conclusion History of diabetes mellitus,degree of tumor infiltration(M3-SM1),inherent muscular layer injury,and persistent hypoxemia may all increase the risk of refractory stenosis after thoracoscopic surgery in patients with esophageal cancer.Early targeted and reasonable intervention in patients with esophageal cancer with the above risk factors may have positive significance to reduce the incidence of refractory stenosis and improve the prognosis of patients.