微创手术与左侧开胸食管切除颈部吻合术治疗中下段食管癌的效果比较  

Comparison of effects of minimally invasive surgery versus left thoracotomy esophagectomy combined with neck anastomosis on middle and lower esophageal cancer

作　　者：张新华 李小兵 吴俊鹏 王虎 师晓天 Zhang Xinhua;Li Xiaobing;Wu Junpeng;Wang Hu;Shi Xiaotian(The First Department of Thoracic,Anyang Cancer Hospital,the Fourth Affiliated Hospital of Henan University of Science and Technology,Anyang 455000,China)

机构地区：[1]河南省安阳市肿瘤医院,河南科技大学第四附属医院胸外一科,455000

出　　处：《中国实用医刊》2021年第13期41-44,共4页Chinese Journal of Practical Medicine

摘　　要：目的:比较微创手术与左侧开胸食管切除颈部吻合术治疗中下段食管癌的效果。方法:抽取2018年8月至2020年8月于安阳市肿瘤医院接受微创手术治疗的46例中下段食管癌患者为观察组,另抽取同期来医院行左侧开胸食管切除颈部吻合术的43例中下段食管癌患者为对照组。比较两组患者手术情况(术中出血量、手术时间、清扫淋巴结个数、术后住院时间)及术后并发症发生情况。比较两组患者术前、术后2周呼吸功能[第1秒用力呼气容积(FEV1)、肺活量(VC)]。结果:观察组术中出血量、术后住院时间均少于对照组,清扫淋巴结个数多于对照组(P<0.05);两组患者手术时间比较差异未见统计学意义(P>0.05)。观察组肺炎发生率(2.17%,1/46)低于对照组(13.95%,6/43),P<0.05;两组患者吻合口瘘、肺不张、胸腔积液、胃排空障碍、心律失常、乳糜胸发生率比较差异均未见统计学意义(P均>0.05)。术后2周,两组患者FEV1、VC均较术前下降,但观察组FEV1、VC高于对照组(P<0.05)。结论:与左侧开胸食管切除颈部吻合术治疗中下段食管癌比较,微创手术可减少患者手术创伤,减少术后并发症的发生,且对患者呼吸功能影响更小。Objective To compare the effects of minimally invasive surgery versus left thoracotomy esophagectomy combined with neck anastomosis in the treatment of middle and lower esophageal cancer.Methods A total of 46 patients with middle and lower esophageal cancer who underwent minimally invasive surgery in Anyang Cancer Hospital from August 2018 to August 2020 were selected as observation group.And another 43 patients with middle and lower esophageal cancer who underwent left thoracotomy esophagectomy combined with neck anastomosis in the hospital during the same period were selected as control group.The surgical condition(intraoperative blood loss,surgical time,number of dissected lymph nodes,postoperative hospital stay)and postoperative complications were compared between the two groups.And the respiratory function,assessed by forced expiratory volume in 1 second(FEV1)and vital capacity(VC),were compared between the two groups before surgery and 2 weeks after surgery.Results The intraoperative blood loss and postoperative hospital stay of observation group were less than those of control group,and the number of dissected lymph nodes was more than that of control group(P<0.05).There was no significant difference in surgical time between the two groups(P>0.05).The incidence of pneumonia in observation group was 2.17%(1/46),lower than the 13.95%(6/43)in control group(P<0.05);but there was no significant difference in the incidence of anastomotic leakage,atelectasis,pleural effusion,delayed gastric emptying,arrhythmia and chylothorax between the two groups(all P>0.05).At 2 weeks after surgery,the FEV1 and VC of the two groups were reduced,compared to those before surgery,however,FEV1 and VC of observation group were higher than those of control group(P<0.05).Conclusions Compared with left thoracotomy esophagectomy combined with neck anastomosis in the treatment of middle and lower esophageal cancer,minimally invasive surgery can better reduce surgical trauma,lower occurrence of postoperative complications,and it has smal

关 键 词：食管癌 微创手术 左侧开胸 并发症 应激反应 

分 类 号：R735.1[医药卫生—肿瘤]