左胸后外侧单切口与右胸腹双切口在食管癌手术中的应用效果比较  

Comparison of the application effect of left posterolateral thoracic single incision and right thoracoabdominal double incision in esophageal cancer surgery

作　　者：王林毛 田雨 刘国锋 孙健 WANG Linmao;TIAN Yu;LIU Guofeng;SUN Jian(Thoracic Surgery Department,the Fourth Affiliated Hospital of Nantong University/Yancheng No.1 People's Hospital,Nantong 224000,China)

机构地区：[1]南通大学第四附属医院/盐城市第一人民医院胸外科,江苏南通224000

出　　处：《临床医学研究与实践》2023年第10期48-51,共4页Clinical Research and Practice

摘　　要：目的 比较左胸后外侧单切口、右胸腹双切口在食管癌手术中的应用效果。方法 选取2015年1月至2017年12月前来我院就诊的160例食管癌患者作为研究对象,遵循随机数字表法将其分为对照组和观察组,每组80例。对照组开展右胸腹双切口食管癌根治术,观察组开展左胸后外侧单切口食管癌根治术。比较两组的治疗效果。结果 观察组的手术时间、住院时间均短于对照组,术中出血量、淋巴结清扫数量均少于对照组,差异具有统计学意义(P<0.05);两组的术后拔管时间无显著差异(P>0.05)。术前,两组的C反应蛋白(CRP)、皮质醇(Cor)水平无显著差异(P>0.05);术后24 h,观察组的CRP、Cor水平均低于对照组,差异具有统计学意义(P<0.05)。术前,两组的肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-8(IL-8)水平无显著差异(P>0.05);术后24 h,观察组的TNF-α、IL-4、IL-8水平低于对照组,差异具有统计学意义(P<0.05)。观察组的术后并发症总发生率为2.50%,显著低于对照组的13.75%,差异具有统计学意义(P<0.05)。出院时,两组的吞咽功能评分无显著差异(P>0.05);出院后1、3个月,观察组的吞咽功能评分显著低于对照组,差异具有统计学意义(P<0.05)。观察组1、3年的生存率均显著高于对照组,差异具有统计学意义(P<0.05);两组5年的生存率无显著差异(P>0.05)。结论 左胸后外侧单切口入路在食管癌根治术中的应用效果更好,可缩短手术时间,减少出血量,提高淋巴结清扫率,有效减轻患者的应激反应,改善其炎性因子水平及吞咽功能,降低并发症发生率,提升生存率。Objective To compare the application effect of left posterolateral thoracic single incision and right thoracoabdominal double incision in esophageal cancer surgery.Methods A total of 160 patients with esophageal cancer who came to our hospital from January 2015 to December 2017 were selected as the study objects.The patients were divided into control group and observation group according to the random number table method,with 80 cases in each group.The control group underwent right thoracoabdominal double incision radical resection of esophageal cancer,and the observation group underwent left posterolateral thoracic single incision radical resection of esophageal cancer.The therapeutic effects of the two groups were compared.Results The operation time and hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss and the number of lymph node dissection were less than those of the control group,and the differences were statistically significant(P<0.05);there was no significant difference in postoperative extubation time between the two groups(P>0.05).Before surgery,there were no significant differences in the levels of C-reactive protein(CRP)and cortisol(Cor)between the two groups(P>0.05);at 24 h after surgery,the levels of CRP and Cor in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in the levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4)and interleukin-8(IL-8)between the two groups(P>0.05);at 24 h after surgery,the levels of TNF-α,IL-4 and IL-8 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 2.50%,which was significantly lower than 13.75%in the control group,and the difference was statistically significant(P<0.05).At discharge,there was no significant d

关 键 词：左胸后外侧单切口 右胸腹双切口 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]