全胸腹腔镜下食管癌根治术对食管癌患者手术指标、免疫功能及生活质量的影响

The effects of total thoracoscopic laparoscopic radical resection for esophageal cancer on surgical indicators,immune function and quality of life in patients with esophageal cancer

目的分析胸腹腔镜下食管癌根治术对食管癌的治疗效果。方法2020年1月至2021年1月我院收治的133例食管癌患者,其中传统根治手术61例(对照组),全胸腹腔镜下食管癌根治术72例(腹腔镜组)。对比两组手术指标、7 d后免疫功能、手术并发症;比较术后3个月生命质量测定量表(QLQ-C30)评分及12个月内复发率情况。结果腹腔镜组手术指标优于对照组(P<0.05),两组淋巴结清扫情况比较差异无统计学意义(P>0.05);治疗后腹腔镜组自然杀伤细胞(NK细胞)、CD4^(+)、CD4^(+)/CD8^(+)值高于对照组(P<0.05);治疗后两组心理功能、社会功能、物质生活、躯体功能评分均升高,且腹腔镜组均高于对照组(P<0.05);腹腔镜组并发症发生率、复发率均低于对照组(P<0.05)。结论全胸腹腔镜下食管癌根治术治疗对食管癌患者治疗效果更优,有利于患者恢复,对术后生活质量有积极的影响。

Objective To analyze the therapeutic effect of thoracoscopic laparoscopic radical esophagectomy in the treatment of esophageal cancer.Methods One hundred and thirty-three patients with esophageal cancer treated in our hospital from January 2020 to January 2021 were selected.The patients were divided into a control group(n=61 treated with traditional radical surgery)and a laparoscopic group(n=72 treated with total thoracoscopic laparoscopic radical surgery.The surgical indexes,immune function after 7 days of operation and surgical complications were compared between the two groups.The quality of life scale(QLQ-C30)score after 3 months of operation and recurrence rate within 12 months were also compared between the two groups.Results The operative indexes in the laparoscopic group were better than those in the control group(P<0.05).There was no significant difference in lymph node dissection between the two groups(P>0.05).After treatment,the values of NK cells,CD4^(+)and CD4^(+)/CD8^(+)in the laparoscopic group were higher than those in the control group(P<0.05).After treatment,the scores of psychological function,social function,material life and physical function in the two groups were all increased,and the scores in the laparoscopic group were higher than those in the control group(P<0.05).The total incidence of complications and recurrence rate in the laparoscopic group were lower than those in the control group(P<0.05).Conclusion The curative effect of total thoracoscopic laparoscopic radical esophagectomy for esophageal cancer patients is better.It is beneficial to the recovery of patients and has a positive impact on the quality of life after operation.