充气纵隔镜与胸腔镜联合腹腔镜手术治疗早期食管癌的临床效果比较  

Comparison of Clinical Effects on Pneumatic Mediastinoscopy and Thoracoscopic Combined with Laparoscopic Surgery in the Treatment of Early Esophageal Cancer

作　　者：卢万里[1] 王俊钢[1] 郝蒙福 LU Wanli;WANG Jungang;HAO Mengfu(Department of Thoracic Surgery,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院胸外科,河南南阳473000

出　　处：《河南医学研究》2025年第3期460-463,共4页Henan Medical Research

摘　　要：目的 分析充气纵隔镜与胸腔镜联合腹腔镜手术治疗早期食管癌的效果。方法 选取2019年6月至2022年1月在南阳市中心医院进行手术治疗的早期食管癌患者86例实施研究,根据手术方式分为对照组(接受胸腔镜联合腹腔镜食管癌切除术,42例)与观察组(接受充气纵隔镜联合腹腔镜食管癌切除术治疗,44例)。对比两组患者手术相关指标、肺功能指标[用力肺活量占预计值百分比(FVC%)、最大自主通气量占预计值百分比(MVV%)、最大呼气量占预计值百分比(FEV%)]、炎症指标水平[白介素-6(IL-6)、白介素-8(IL-8)、白介素-10(IL-10)]及并发症发生率与复发率。结果 与对照组相比,观察组术中出血量、术后1 d引流量更少,拔出胸管时间、术后住院时间更短(P<0.05);经过手术治疗后,两组FVC%、MVV%、FEV%、IL-6、IL-8、IL-10水平均呈降低趋势,且相较于对照组,观察组FVC%、MVV%、FEV%水平更高,IL-6、IL-8、IL-10水平更低(P<0.05);两组患者术后并发症发生率以及1 a复发率差异无统计学意义(P>0.05)。结论 充气纵隔镜联合腹腔镜食管癌切除术可以减轻手术创伤,改善手术指标,减少对肺功能的伤害,降低炎症因子水平,值得临床推广。Objective To analyze the clinical application of pneumatic mediastinoscopy and thoracoscopic combined with laparoscopic surgery in the treatment of early esophageal cancer.Methods A total of 86 patients with early esophageal cancer who underwent surgical treatment in Nanyang Central Hospital from June 2019 to January 2022 were selected for the study.According to the surgical method,they were divided into control group(receiving thoracoscopy combined with laparoscopic esophageal cancer resection,42 cases)and observation group(receiving inflatable mediastinoscopy combined with laparoscopic esophageal cancer resection,44 cases).The operation related indexes,pulmonary function indexes[forced vital capacity percentage of predicted value(FVC%),maximum voluntary ventilation percentage of predicted value(MVV%),maximum expiratory volume percentage of predicted value(FEV%)],inflammatory indexes[interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10(IL-10)],incidence of complications and recurrence rate were compared between the two groups.Results Compared with the control group,the observation group had less intraoperative blood loss,less drainage volume at 1 day after operation,shorter chest tube removal time,and shorter postoperative hospital stay(P<0.05).After surgical treatment,the levels of FVC%,MVV%,FEV%,IL-6,IL-8 and IL-10 in the two groups showed a decreasing trend,and compared with the control group,the levels of FVC%,MVV%and FEV%in the observation group were higher,and the levels of IL-6,IL-8 and IL-10 were lower(P<0.05).There was no difference in the incidence of postoperative complications and 1-year recurrence rate between the two groups(P>0.05).Conclusion Pneumatic mediastinoscopy combined with laparoscopic esophageal cancer resection can reduce surgical trauma,improve surgical indicators,reduce damage to lung function,and reduce the level of inflammatory factors,which is worthy of clinical promotion.

关 键 词：早期食管癌 充气纵隔镜:胸腔镜 腹腔镜 

分 类 号：R655.4[医药卫生—外科学]