全腔镜下食管癌根治术患者双管胸腔引流对围术期并发症的影响

Effect of double-tube thoracic drainage on perioperative complications in total endoscopic radical esophagectomy

目的比较胸腔-纵隔双管胸腔引流和单管胸腔引流对全腔镜下食管癌根治术(TERE)围术期吻合口瘘、食管气管瘘等并发症的发生情况。方法回顾性分析2018年1月至2021年1月东部战区总医院胸外科行TERE的105例食管癌患者临床资料。根据术中是否放置双管胸腔引流进行分组:双管组(双管胸腔引流,n=45)及单管组(单管胸腔引流,n=60)。比较两组围术期吻合口瘘、食管气管瘘并发症的发生情况。结果双管组围术期吻合口瘘的发生率显著低于单管组(4.4%vs 25.0%,P=0.005),在食管气管瘘(0%vs 1.6%)、住院总时间(15d vs 17d)、住院总费用(93530元vs 98464元)方面差异无统计学意义(P>0.05)。结论采用TERE双管胸腔引流可以有效降低患者围术期食管吻合口瘘的发生率,改善了患者的预后。

Objective To compare the incidence of anastomotic fistula,esophagotracheal fistula and other complications during the perioperative period of total endoscopic radical esophagotomy(TERE)with double-tube thoracic drainage and single-tube thoracic drainage.Methods There is a retrospective analysis of the clinical data for 105 patients with esophageal cancer who underwent TERE in the Department of Thoracic Surgery of Eastern Theater General Hospital from January 2018 to January 2021.The patients were divided into two groups according to whether double-tube thoracic drainage was placed during the operation,namely,the double-tube group(double-tube thoracic drainage,n=45)and the single-tube group(single-tube thoracic drainage,n=60).The complications of anastomotic fistula and esophagotracheal fistula in perioperative period were compared between the two groups.Results The incidence of perioperative anastomotic fistula in the double-tube group was significantly lower than that in the single-tube group(4.4%vs 25.0%,P=0.005).There was no significant difference in esophagotracheal fistula(0%vs 1.6%),total length of stay(15d vs 17d),and total hospitalization cost(93530 yuan vs 98464 yuan)(P>0.05).Conclusion TERE double-tube thoracic drainage can effectively reduce the incidence of esophageal anastomotic fistula in perioperative period and improve the prognosis of patients.