胸腔镜下右胸食管癌根治术治疗食管癌的效果及安全性

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目的观察胸腔镜下经右胸食管癌根治术治疗食管癌的效果及安全性。方法选取2016年1—12月收治的食管癌患者92例,运用随机数表法将其分为观察组与对照组,每组46例。观察组采取胸腔镜下经右胸、上腹食管癌根治术,对照组给予临床常规右剖胸、上腹两切口食管癌根治术。观察两组术前术后1s用力呼气容积(forced expiratory volume in one second,FEV1)与FEV1/用力肺活量(forced vital capacity,FVC)、术中出血量、住院时间与术后并发症发生情况。计数资料比较用χ2检验,计量资料比较用t检验,P<0.05为差异有统计学意义。结果治疗前两组FEV1、FEV1/FVC对比,差异无统计学意义(均P>0.05);治疗后观察组FEV1、FEV1/FVC检测结果[(50.14±4.83)L、(70.58±8.69)%]优于对照组[(49.58±5.26)L、(63.36±7.41)%],且观察组术中出血量(192.36±55.49)m L、住院时间(11.74±2.58)d均少于对照组[(254.21±70.14)m L、(18.25±4.17)d],差异有统计学意义(均P<0.05);观察组术后相关并发症发生率(8.70%)低于对照组(32.61%),差异有统计学意义(P<0.05)。结论胸腔镜下右胸食管癌根治术治疗食管癌疗效确切,利于改善患者肺功能,缩短治疗时间,术后相关并发症发生率低。 Objective To observe the effect and safety of thoracoscopic esophagectomy on right thoracic esophageal cancer. Methods Totally 92 patients with esophageal cancer who were admitted from January to December in 2016 were divided into observation group and control group using random number table method, with 46 cases in each group. The observation group underwent thoracoscopic right thoracic and upper abdominal esophageal cancer radical mastectomy. The control group was given routine right thoracotomy and upper abdominal incision esophagectomy. The forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), blood loss, length of hospital stay and postoperative complications were compared between the two groups before operation. Counting data were compared with χ2 test, measurement data were compared with t test, P <0.05 for the difference was statistically significant. Results There was no significant difference in FEV1 and FEV1 / FVC between the two groups before treatment (all P> 0.05). After treatment, the results of FEV1 and FEV1 / FVC in the observation group [(50.14 ± 4.83) L, (70.58 ± 8.69)%] (49.58 ± 5.26) L, (63.36 ± 7.41)%], and the blood loss in the observation group was (192.36 ± 55.49) m L and the length of hospital stay was (11.74 ± 2.58) d less than that in the control group [( 254.21 ± 70.14) m L, (18.25 ± 4.17) d] (all P <0.05). The incidence of postoperative complications in the observation group (8.70%) was lower than that in the control group (32.61%), There was statistical significance (P <0.05). Conclusions Thoracoscopic right thoracic esophagectomy for the treatment of esophageal cancer is effective in improving lung function, shortening the treatment time and the incidence of postoperative complications.
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