不同手术方式对食管癌患者疗效及其预后的影响

Evaluation of the Effects of Different Surgical Procedures on the Efficacy of Patients with Esophageal Cancer and Their Prognosis

目的探讨手术方式差异对食管癌疗效及其预后的影响。方法选取74例食管癌(中下段)患者作为研究对象,根据手术方式的差异将其分为2组。研究组患者40例,采用胸腹腔镜辅助McKeown食管癌根治术治疗;对照组患者34例,采用胸腔镜上腹-左颈切口McKeown食管癌根治术治疗。比较2组患者的临床疗效等差异。结果研究组的术中失血量、腹腔引流时间、住院时间及术后进食时间均少于对照组(P<0.05),而其余方面比较2组无差别(P>0.05)。术后研究组的并发症发生率(12.5%)显著低于对照组(38.2%)(P<0.05)。术前2组患者的生活质量比较无差异(P>0.05),而术后研究组生活质量比对照组改善明显(P<0.05)。术后1年,2组患者的预后比较无差异(P>0.05)。结论胸腹腔镜辅助McKeown食管癌根治术可显著提高中下段食管癌患者的疗效,同时可降低其术后并发症发生率,并改善其生活质量,且不影响患者的预后,值得临床推广应用。

Objective To investigate the effects of different surgical procedures on the efficacy of patients with esophageal cancer and their prognosis.Methods 74 patients with middle and lower esophageal cancer were selected as the study subjects.They were divided into 2 groups according to the difference of surgical methods.Among them,40 patients in the study group were treated by thoracic-laparoscopic-assisted McKeown radical esophagectomy for esophageal cancer,while 34 patients in the control group were treated by thoracoscopic epigastric-left cervical incision McKeown radical esophagectomy for esophageal cancer,comparing the clinical efficacy and other differences between the 2 groups.Results Intraoperative blood loss,abdominal drainage time,hospital stay and postoperative feeding time were less in study group than in the control group(P<0.05),while there were no differences between the 2 groups in the rest of the comparison(P>0.05);Postoperative complication rate was lower in the study group(12.5%)than in the control group(38.2%)(P<0.05);There was no difference in the quality of life between the 2 groups before surgery(P>0.05).In contrast,the postoperative quality of life in the study group improved significantly compared with the control group(P<0.05);1 year after surgery,there was no difference in the prognosis of the 2 groups(P>0.05).Conclusion Thoraco-laparoscopic-assisted radical resection of McKeown esophageal cancer can significantly improve the outcome of patients with lower segment esophageal cancer in high school,while reducing the incidence of postoperative complications and improving their quality of life without affecting their prognosis,and is worthy of clinical promotion.