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目的:观察胸、腹腔镜食管癌根治术治疗老年食管癌患者的临床疗效及其对肺功能的影响。方法:将197例老年食管癌患者分为2组,对照组(102例)采用传统食管癌切除术治疗,腔镜组(95例)采用胸、腹腔镜食管癌根治术治疗。比较两组患者术中出血量、手术时间、清扫淋巴结数、术后住院时间及术后肺部感染发生率等情况,并检测术前和术后肺功能指标(VC、FEV1.0、MVV)变化。结果:腔镜组手术时间虽然较对照组延长(P<0.05),但术中出血量、术后住院时间及术后肺部感染发生率等均明显少于对照组(P<0.05),且清扫淋巴结数明显多于对照组(P<0.05);两组患者术前肺功能指标(VC、FEV1.0、MVV)比较差异无统计学意义(P>0.05),术后两组患者肺功能指标均明显降低(P<0.05),但腔镜组降低幅度小于对照组(P<0.05)。结论:胸、腹腔镜食管癌根治术治疗老年食管癌患者具有出血少、恢复快、术后并发症少、对肺功能影响较小等优点,值得临床推广应用。
Objective: To observe the clinical efficacy of thoracoscopic and laparoscopic radical resection of esophageal cancer in elderly patients with esophageal cancer and its effect on lung function. Methods: A total of 197 elderly patients with esophageal cancer were divided into two groups. The control group (102 cases) was treated by conventional esophagectomy. The endoscopic group (95 cases) was treated by thoracic and laparoscopic esophageal cancer radical mastectomy. The blood loss, operation time, number of lymph nodes dissected, postoperative hospital stay and the incidence of postoperative pulmonary infection were compared between the two groups. Preoperative and postoperative pulmonary function parameters (VC, FEV1.0, MVV) Variety. Results: Although the operation time in the endoscopic group was longer than that in the control group (P <0.05), the intraoperative blood loss, postoperative hospital stay and the incidence of postoperative pulmonary infection were significantly less than those in the control group (P <0.05) (P <0.05). There was no significant difference in preoperative pulmonary function parameters (VC, FEV1.0, MVV) between the two groups (P> 0.05). The pulmonary function Indicators were significantly lower (P <0.05), but the reduction of endoscopic group was less than the control group (P <0.05). Conclusions: Thoracic and laparoscopic radical resection of esophageal cancer for elderly patients with esophageal cancer has the advantages of less bleeding, faster recovery, less postoperative complications and less impact on pulmonary function, which is worthy of clinical application.