全胸腹腔镜下食管癌根治食管胃颈部机械吻合术后患者生活质量分析  

Analysis of Quality of Life after Total Thoracic Laparoscopic Radical Resection of Esophageal and Gastric Cancer

作　　者：郑勇[1] 闫颖伟 刘俊山 ZHENG Yong;YAN Yingwei;LIU Junshan(Puyang Oilfield General Hospital,Puyang,457000)

机构地区：[1]濮阳市油田总医院,457000

出　　处：《实用癌症杂志》2021年第2期275-279,共5页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划项目(编号:2018062151)。

摘　　要：目的探讨全胸腹腔镜下食管癌根治食管胃颈部机械吻合术对食管癌患者术后生活质量的影响。方法选取78例食管癌患者为研究对象,按入组先后顺序平均分成2组,每组39例。对照组传统开胸手术治疗,研究组全胸腹腔镜下食管癌根治术联合食管胃颈部机械吻合术治疗,观察治疗后在生活质量指标、远期生活质量和住院时间等指标比较。结果治疗后研究组在躯体、角色、情绪、认知、社会功能和症状子量表包括疲倦、恶心与呕吐、疼痛、呼吸困难、失眠、食欲丧失、便秘、腹泻、经济困难以及吞咽困难、进食、反流、疼痛、咽口水、梗阻、口干、食欲减退、咳嗽、言语上均显著优于对照组,两组比较差异显著(P<0.05);研究组远期生活质量吻合口瘘、反流、胸胃综合征、胃瘫、吻合口狭窄发生率分别为28.2%、15.38%、10.26%、12.82%、12.82%,显著低于对照组的58.97%、35.9%、30.77%、35.9%、46.15%,比较差异显著(P<0.05);研究组在术中出血量、创口直径、住院时间上显著优于对照组(P<0.05),而在清扫淋巴结数、手术时间上比较差异不显著(P>0.05)。结论全胸腹腔镜下食管癌根治食管胃颈部机械吻合术治疗食管癌能提高患者术后生活质量,且并发症低,创伤小。Objective To evaluate the effect of radical resection of esophageal and gastric cancer on the quality of life in patients with esophageal carcinoma after total laparoscopic chest surgery.Methods 78 patients with esophageal cancer were enrolled in the study.They were divided into 2 groups according to the order of the patients in each group.There were 39 patients in each group.The control group was treated with traditional open chest surgery.The study group was treated with total thoracic laparoscopic radical resection of esophageal cancer combined with mechanical anastomosis of esophagus and stomach neck.The quality of life indicators and complications were compared.Results After treatment in the study group of body,role,emotion,cognition,social function and symptom scales include tiredness,nausea and vomiting,pain,dyspnea,insomnia,loss of appetite,constipation,diarrhea,economic difficulties and difficulty in swallowing,eating,reflux,pain,pharynx slobber,obstruction,dry mouth,appetite loss,cough,words were significantly better than the control group,there was significant difference between the 2 groups(P<0.05);Study on the quality of life of long-term anastomotic fistula,reflux,thoracic stomach syndrome,gastroparesis and anastomotic stenosis rate were 28.21%,15.38%,10.26%,12.82%,12.82%,significantly lower than the control group 58.97%,35.9%,30.77%,35.9%,46.15%,and there was significant difference(P<0.05);blood,wound diameter,hospitalization time was significantly better than the control group in the study group during operation(P<0.05)in comparison,the number of lymph nodes,the operation time has no significant difference(P>0.05).Conclusion Radical resection of esophageal carcinoma with esophageal and gastric neck by whole chest laparoscopic surgery for esophageal carcinoma can improve the postoperative quality of life,and the complications are low and the trauma is small.

关 键 词：全胸腹腔镜下食管癌根治术 食管胃颈部机械吻合术 生活质量 

分 类 号：R735.1[医药卫生—肿瘤]