胸腔镜辅助Ivor-Lewis术在食管癌治疗中的应用效果及对患者免疫功能、肺功能的影响

Effect of Video Assisted Ivor Lewis Surgery in the Treatment of Esophageal Cancer and Its Influence on Immune Function and Lung Function

目的探讨胸腔镜辅助Ivor-Lewis术在食管癌治疗中的应用效果及其对患者免疫功能、肺功能的影响。方法选择88例食管癌患者为研究对象,随机分为2组,其中对照组44例患者均采取常规手术治疗,研究组44患者采取胸腔镜辅助Ivor-Lewis术,比较2组患者的围手术期指标、术后恢复情况、呼吸功能、免疫功能以及并发症之间的差异。结果研究组患者的术中出血量较对照组少,差异具有统计学意义(P<0.05)。研究组术后拔管时间、引流量、住院时间均较对照组低,差异具有统计学意义(P<0.05)。治疗后,2组患者的肺功能均优于治疗前,且研究组肺功能指标改善情况均优于对照组,差异具有统计学意义(P<0.05)。治疗后,2组患者的免疫指标水平显著升高,且研究组患者升高水平较对照组高,差异具有统计学意义(P<0.05)。2组患者术后吻合口瘘、肺部感染、脓胸等并发症总发生率对比,差异不存在统计学意义(P>0.05)。结论和常规手术相比,胸腔镜辅助Ivor-Lewis术更有利于食管癌患者术后恢复,能够更好地改善患者术后的免疫功能,对肺功能影响较小,且不增加并发症发生风险。

Objective To analyze the effect of video-assisted Ivor Lewis surgery in the treatment of esophageal cancer and its influence on immune function and lung function.Methods 88 cases of esophageal cancer patients were randomly divided into 2 groups,44 cases in the control group were treated with conventional surgery,and 44 cases in the study group were treated with VATS assisted Ivor Lewis surgery.Compared the perioperative indicators,postoperative recovery,respiratory function,immune function,and complications of the 2 group.Results The amount of bleeding in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The extubation time,drainage volume and hospitalization time of the study group were lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the improvement of pulmonary function indexes of the 2 groups were better than before treatment,and the improvement of pulmonary function indexes of the study group was better than that of the control group,the difference was statistically significant(P<0.05).After treatment,the immune index levels of the 2 groups were significantly increased,and the increase level of the study group was higher than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications such as anastomotic leakage,pulmonary infection and empyema between the 2 groups(P>0.05).Conclusion Compared with conventional surgery,VATS assisted Ivor Lewis has better recovery effect in patients with esophageal cancer,can improve postoperative immune function,and has less impact on lung function.