胸腔镜食管癌根治术联合左侧颈部吻合术治疗食管癌的效果及对呼吸功能的影响

Therapeutic effect of thoracoscopic radical esophagectomy combined with left cervical anastomosis on esophageal neoplasms and its influence on respiratory function

目的探讨胸腔镜食管癌根治术联合左侧颈部吻合术治疗食管癌的效果及对患者呼吸功能的影响。方法抽取开封市肿瘤医院2018年1月至2020年12月收治的食管癌患者72例作为研究对象,按照随机数字表法分为对照组(36例)和研究组(36例)。对照组采用传统经右胸食管癌切除术联合胃食管胸内吻合术治疗,研究组采用胸腔镜食管癌根治术联合左侧颈部吻合术治疗。比较两组围术期指标、视觉模拟评分法(VAS)评分、呼吸功能[第1秒用力呼气容积(FEV1)、最大通气量(MVV)、最大呼气流速(PEF)、肺活量(FVC)]及术后并发症发生率。结果与对照组比较,研究组手术时间较长、术中出血量较少、住院时间较短(P<0.05);术后12、24、48 h,研究组VAS评分均低于对照组(P均<0.05);术后1个月,研究组FEV1、MVV、PEF、FVC水平高于对照组(P<0.05)。研究组术后并发症发生率(8.33%,3/36)低于对照组(30.56%,11/36),P<0.05。结论胸腔镜食管癌根治术联合左侧颈部吻合术治疗食管癌效果较好,能减少术中出血量,缩短住院时间,减轻术后疼痛,减轻对患者呼吸功能的影响,术后并发症发生率低。

Objective To investigate the therapeutic effect of thoracoscopic radical esophagectomy combined with left cervical anastomosis on esophageal neoplasms and its influence on respiratory function.Methods Seventy-two patients with esophageal carcinoma treated in Kaifeng Cancer Hospital from January 2018 to December 2020 were selected as research objects,and they were divided into control group(36 cases)and study group(36 cases)according to random number table method.The control group was treated by traditional esophagectomy via right thoracic approach combined with esophagogastrostomy,while the study group was treated by thoracoscopic esophagectomy combined with left cervical anastomosis.The perioperative indexes,visual analogue scale(VAS)score,respiratory function assessed by forced expiratory volume in 1 second(FEV1),maximum ventilation volume(MVV),peak expiratory flow(PEF)and forced vital capacity(FVC),and postoperative complication rate were compared between the two groups.Results Compared with the control group,the study group had longer operation time,less intraoperative blood loss and shorter hospital stay(P<0.05).Compared with the control group,VAS scores of the study group were lower at 12,24 and 48 hours after surgery(all P<0.05).Compared with the control group,the levels of FEV1,MVV,PEF and FVC in the study group were higher 1 month after surgery(P<0.05).The incidence of complications of the study group(8.33%,3/36)was lower than that of the control group(30.56%,11/36),P<0.05.Conclusions Thoracoscopic radical esophagectomy combined with left cervical anastomosis has good effects in the treatment of esophageal neoplasms,which can reduce intraoperative blood loss,shorten hospital stay,relieve postoperative pain,reduce the impact on patients’respiratory function,and reduce the incidence of postoperative complications.