胸腔镜食管癌根治术+颈部吻合术治疗老年食管癌的疗效及安全性分析  

Analysis of the efficacy and safety of video assisted thoracoscopic surgery+cervical anastomosis in elderly patients with esophageal cancer

作　　者：陈颖 王俊钢[1] 李伟[1] 段东奎[1] CHEN Ying;WANG Jungang;LI Wei;DUAN Dongkui(Department of Thoracic Surgery,Nanyang Central Hospital(Nanyang Cancer Hospital),Nanyang 473000,He’nan,China)

机构地区：[1]南阳市中心医院(南阳市肿瘤医院)胸外科,河南南阳473000

出　　处：《癌症进展》2025年第5期603-606,共4页Oncology Progress

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200907)。

摘　　要：目的探讨胸腔镜食管癌根治术+颈部吻合术治疗老年食管癌的疗效及安全性。方法根据手术方式的不同将116例老年食管癌患者分为观察组(59例,采取胸腔镜食管癌根治术+颈部吻合术)和对照组(57例,采取常规食管癌根治术),比较两组患者的临床指标、呼吸功能指标[第1秒用力呼气容积(FEV1)、呼气流量峰值(PEF)及用力肺活量(FVC)]及并发症发生情况。结果观察组患者术中出血量明显少于对照组,术后拔管时间、住院时间均明显短于对照组,手术时间明显长于对照组,术后24 h时视觉模拟评分法(VAS)评分明显低于对照组,差异均有统计学意义(P﹤0.01)。术后,观察组患者PEF、FVC、FEV1均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率明显低于对照组,差异有统计学意义(P﹤0.01)。结论老年食管癌患者采取胸腔镜食管癌根治术+颈部吻合术可减少对呼吸功能的影响,促进患者术后恢复,降低并发症发生风险,有临床应用价值。Objective To explore the efficacy and safety of video assisted thoracoscopic surgery+cervical anastomosis in elderly patients with esophageal cancer(EC).Method A total of 116 elderly patients with EC were divided into observation group(video assisted thoracoscopic surgery+cervical anastomosis,59 cases)and control group(conventional radical resection of EC,57 cases)according to the different surgical methods.The clinical indicators,respiratory function indicators[forced expiratory volume in one second(FEV1),peak expiratory flow(PEF)and forced vital capacity(FVC)]and complications were compared between the two groups.Result The blood loss in the observation group was significantly less than that in the control group,the extubation time and hospitalization time were significantly shorter than those in the control group,the operation time was significantly longer than that in the control group,and the visual analogue scale(VAS)score at 24 hours after operation was significantly lower than that in the control group,the differences were statistically significant(P<0.01).After the operation,the PEF,FVC and FEV1 in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.01).Conclusion Video assisted thoracoscopic surgery+cervical anastomosis in elderly patients with EC can reduce the impact on respiratory function,promote postoperative recovery and reduce the risk of complications,which has clinical application value.

关 键 词：食管癌 胸腔镜食管癌根治术 颈部吻合术 并发症 

分 类 号：R735.1[医药卫生—肿瘤]