胸腹腔镜联合食管癌根治术的疗效分析  

Effect of Radical Esophagectomy with Thoracoscopy and Laparoscopy on Patients with Esophageal Cancer

作　　者：李冬冬[1] LI Dong-dong(Yongcheng People’s Hospital Oncology Surgery,Yongcheng,China,476600)

机构地区：[1]永城市人民医院肿瘤外科,河南永城476600

出　　处：《食管疾病》2021年第3期182-185,共4页Journal of Esophageal Diseases

摘　　要：目的分析胸腹腔镜联合食管癌根治术治疗食管癌患者的疗效及安全性。方法选取2018年5月至2020年11月我院食管癌患者82例,依照随机数字表法分为两组,各41例。对照组接受开胸手术治疗,观察组接受胸腹腔镜联合食管癌根治术治疗,比较两组治疗效果。结果两组手术时长、淋巴结清扫数量对比,差异无统计学意义(P>0.05)。观察组术中失血量较对照组少,切口较对照组小,住院时间较对照组短(P<0.05);应激反应:术后1 d、3 d,两组血清皮质醇(Cor)、去甲肾上腺素(NE)均高于术前,但观察组低于对照组(P<0.05);肺功能:术后7 d,两组肺功能均有所降低,但观察组用力呼吸肺活量(FVC)、第一秒末用力呼气容积(FEV_(1))均高于对照组(P<0.05);并发症:观察组胸胃综合征、反流、胃瘫、吻合口狭窄发生率较对照组低(P<0.05)。结论胸腹腔镜联合食管癌根治术治疗食管癌,效果确切,能有效优化围术期指标,减小对患者应激反应、肺功能的影响,且安全性高。Objective To analyze the efficacy and safety of radical esophagectomy with thoracoscopy and laparoscopy in the treatment of esophageal cancer.Methods 82 patients with esophageal cancer in our hospital from May 2018 to November 2020 were selected.82 patients with esophageal cancer in our hospital(may 2018 to November 2020)were randomly divided into two groups with 41 cases in each group.The control group received thoracotomy and the observation group received thoracoscopy combined with radical esophagectomy.The therapeutic effects of the two groups were compared.Results Results operation and recovery:there was no significant difference in the operation time and the number of lymph node dissections between the two groups(P>0.05),but the intraoperative blood loss,incision and hospital stay in the observation group were less than those in the control group(P<0.05);Stress response:on the 1st and 3rd day after operation,the serum cortisol(COR)and norepinephrine(NE)in the two groups were higher than those before operation,but those in the observation group were lower than those in the control group(P<0.05);Pulmonary function:7 days after operation,the pulmonary function of the two groups decreased,while the forced respiratory vital capacity(FVC)and forced expiratory volume at the end of the first second(FEV_(1))in the observation group were higher than those in the control group(P<0.05);Complications:the incidence of thoracic gastric syndrome,reflux,gastroparesis and anastomotic stenosis in the observation group was lower than that in the control group(P<0.05).Conclusion thoracoscopic laparoscopic surgery combined with radical esophagectomy is effective in the treatment of esophageal cancer.It can effectively optimize the perioperative indexes,reduce the impact on patients'stress response and pulmonary function,and has high safety.

关 键 词：食管癌根治术 食管胃颈部机械吻合术 胸腹腔镜 应激反应 肺功能 

分 类 号：R719.8[医药卫生—妇产科学]