胸腹腔镜联合治疗食管癌对纵膈淋巴结的清扫效果及对肺功能的影响  

The Effect of Mediastinal Lymphadenectomy and Lung Function in the Treatment of Esophageal Carcinoma by Thoracoscope Combined with Laparoscope

作　　者：袁延亮 张成 陈志鹏 YUAN Yanliang;ZHANG Cheng;CHEN Zhipeng(Department of Thoracic Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China)

机构地区：[1]徐州医科大学附属医院胸外科,江苏徐州221000

出　　处：《系统医学》2025年第3期107-110,共4页Systems Medicine

基　　金：徐州医科大学附属医院院级科研项目(2020KC012)。

摘　　要：目的探讨胸腔镜和腹腔镜联合应用治疗食管癌时,对纵膈淋巴结的清除效果及对肺功能的影响。方法回顾性选取2020年1月—2023年3月徐州医科大学附属医院胸外科收治的80例食管癌患者的临床资料,根据治疗方法不同分为两组,各40例。行胸腹腔镜下食管癌根治术的设为腔镜组,行胸腹两切口式根治术的设为开放组。对比两组淋巴结清除效果、肺功能、并发症发生情况、生活质量。结果腔镜组纵膈淋巴结清扫数多于开放组,术中出血少于开放组,差异有统计学意义(P均<0.05)。术后腔镜组肺功能优于开放组,差异有统计学意义(P均<0.05)。腔镜组并发症总发生率为2.5%(1/40),低于开放组的20.0%(8/40),差异有统计学意义(χ^(2)=4.507,P<0.05)。腔镜组生活质量评分高于开放组,差异有统计学意义(P<0.05)。结论胸腹腔镜联合下食管癌根治,创伤小,出血少,在清除更多的纵膈淋巴结的基础上,减少对肺功能的影响和术后并发症的发生,有利于改善患者的生活质量。Objective To investigate the effect of thoracoscopy and laparoscopy on clearance of mediastinal lymph nodes and lung function in the treatment of esophageal cancer.Methods The clinical data of eighty patients with esophageal cancer in the Department of Thoracic Surgery,Affiliated Hospital of Xuzhou Medical University from January 2020 to March 2023 were retrospectively selected,according to different treatment methods,they were divided into two groups,forty cases in each group.The patients who underwent laparoscopic radical resection of esophageal cancer were assigned to the endoscopic group and the patients who underwent two-incision radical resection of the chest and abdomen were assigned to the open group.The lymph node clearance effect,lung function,complications and quality of life were compared between the two groups were compared between the two groups.Results The number of mediastinal lymph node dissection in the endoscopic group was higher than that in the open group,and the intraoperative bleeding was lower than that in the open group,the differences were statistically significant(both P<0.05).After surgery,the pulmonary function of the endoscopic group was better than that of the open group,and the differences were statistically significant(all P<0.05).The total incidence of complications in the endoscopic group was 2.5%(1/40),lower than 20.0%(8/40)in the open group,and the difference was statistically significant(χ^(2)=4.507,P<0.05).The quality of life score of the endoscopic group was higher than that of the open group,and the difference was statistically significant(P<0.05).Conclusion Thoracic laparoscopy combined with radical treatment of lower esophageal cancer has less trauma and less bleeding.On the basis of removing more mediastinal lymph nodes,it can reduce the impact on lung function and the occurrence of postoperative complications,which is conducive to improving the quality of life of patients.

关 键 词：胸腹腔镜 食管癌 纵膈淋巴结 肺功能 

分 类 号：R4[医药卫生—临床医学]