胸腹腔镜联合三切口食管癌根治术治疗食管中上段癌患者的短期随访  

Short-Term Follow-up of Thoracic Laparoscopy Combined with Three-Incision Radical Esophagectomy in the Treatment of Middle and Upper Esophageal Cancer

作　　者：武志强 WU Zhiqiang(Department of General Thoracic Surgery,the Second People’s Hospital of Zhenping County,Nanyang 474250,China)

机构地区：[1]镇平县第二人民医院普胸外科,河南南阳474250

出　　处：《河南医学研究》2021年第17期3153-3155,共3页Henan Medical Research

摘　　要：目的探讨胸腹腔镜联合三切口食管癌根治术治疗食管中上段癌患者的效果。方法选取镇平县第二人民医院2018年9月至2019年8月收治的85例食管中上段癌患者,根据手术方案分为对照组(42例)和观察组(43例)。对照组接受三切口食管癌根治术治疗,观察组接受胸腹腔镜联合三切口食管癌根治术治疗。比较两组手术相关指标、术前及术后1 d免疫功能相关指标(CD4^(+)、CD8^(+))、术后并发症发生情况;随访6个月,统计两组生存情况以及肿瘤远处转移情况。结果观察组术中出血量少于对照组,淋巴结清扫数量多于对照组,首次排气时间、住院时间短于对照组(P<0.05)。术后1 d,两组CD4^(+)、CD8^(+)水平低于术前(P<0.05);术后1 d,观察组CD4^(+)、CD8^(+)水平高于对照组(P<0.05)。观察组并发症发生率(16.28%)低于对照组(23.81%),差异无统计学意义(P>0.05)。观察组生存概率(97.50%)高于对照组(92.68%),差异无统计学意义(P>0.05);观察组肿瘤远处转移率(15.00%)低于对照组(21.95%),差异无统计学意义(P>0.05)。结论胸腹腔镜联合三切口食管癌根治术治疗食管中上段癌患者,可减轻手术创伤,提高淋巴结清扫效率,减轻免疫损伤,促进术后恢复,具有一定安全性。Objective To explore the effect of thoracic laparoscopy combined with three-incision radical esophagectomy in the treatment of patients with middle and upper esophageal cancer.Methods A total of 85 patients with middle and upper esophageal cancer from September 2018 to August 2019 in the Second People’s Hospital of Zhenping County were selected and divided into two groups according to the surgical plans.There were 43 cases in observation group,and they were treated with thoracic laparoscopy combined with three-incision radical esophagectomy.There were 42 cases in control group,and they were treated with three-incision radical esophagectomy.The surgery-related indicators,the immune function indicators(CD4^(+),CD8^(+))of before and one day after operation and postoperative complications were compared between the two groups.The survival and distant metastasis of the two groups were analyzed after six months’follow-up.Results The blood loss during operation in observation group was less than control group.The number of lymph node dissections in observation group was more than that in control group.The first exhaust time and hospital stay in observation group were shorter than those in control group(P<0.05).One day after operation,the levels of CD4^(+)and CD8^(+)in observation group were higher than those in control group(P<0.05).The postoperative complication rate(16.28%)in observation group was lower than that in control group(23.81%),and there was no statistical difference(P>0.05).The survival rate of observation group(97.50%)was higher than that in control group(92.68%),and there was no statistical difference(P>0.05).The distant metastasis rate of observation group(15.00%)was lower than that in control group(21.95%),and there was no statistical difference(P>0.05).Conclusion Thoracic laparoscopy combined with three-incision radical esophagectomy could reduce surgical trauma in patients with upper and middle esophageal cancer,improve the efficiency of lymph node dissection,reduce immune function damage,promote p

关 键 词：食管中上段癌 三切口食管癌根治术 胸腹腔镜 

分 类 号：R735.1[医药卫生—肿瘤]