摘要
目的:探讨胸腹腔镜Ivor-Lewis手术治疗食管中下段癌的疗效,并分析对患者肺功能及免疫功能的影响。方法:选取我院收治的食管中下段癌患者82例,根据手术方式不同分为观察组(n=42)和对照组(n=40)。观察组行胸腹腔镜Ivor-Lewis食管癌切除术,对照组行传统开放Ivor-Lewis食管癌切除术。观察两组患者围手术期指标及术后并发症,分别于术前、术后1月检测患者的肺功能,于术前1天、术后7天检测患者的免疫功能。结果:观察组与对照组的手术时间无统计学差异(P>0.05)。观察组术中出血、留置胸引管时间、住院时间少于对照组,差异有统计学意义(P<0.05)。观察组与对照组喉返神经损伤、吻合口瘘发生率无统计学差异(P>0.05),观察组肺部感染、心律失常低于对照组,差异有统计学意义(P<0.05)。观察组术后1月肺功能各项指标均高于对照组,差异有统计学意义(P<0.05)。观察组术后CD3+、CD4+、CD4+/CD8+均高于对照组,CD8+低于对照组,差异有统计学意义(P<0.05)。结论:胸腹腔镜Ivor-Lewis手术治疗食管中下段癌能减少手术创伤,降低术后并发症,减轻对患者肺功能、免疫功能的影响,有利于患者快速康复,值得临床推广应用。
Objective:To investigate the therapeutic effect of thoracoscopic and laparoscopic Ivor-Lewis surgery for middle and lower esophageal cancer,and analyze the influence on pulmonary function and immune function of patients.Methods:82 patients with middle and lower esophageal cancer admitted to our hospital were selected and divided into observation group(n=42)and control group(n=40)according to different surgical methods.The observation group received thoracoscopic and laparoscopic Ivor-Lewis esophagectomy,while the control group received traditional open Ivor-Lewis esophagectomy.The perioperative indexes and postoperative complications of the two groups of patients were observed.The pulmonary function of the patients was detected before operation and 1 month after operation respectively,and the immune function of the patients was detected 1 day before operation and 7 days after operation.Results:There was no statistical difference in the operation time between the observation group and the control group(P>0.05).The observation group had less intraoperative bleeding,indwelling thoracic catheterization time and hospitalization time than the control group(P<0.05).There was no significant difference in the incidence of recurrent laryngeal nerve injury and anastomotic leakage between the observation group and the control group(P>0.05).The incidence of pulmonary infection and arrhythmia in the observation group was lower than that in the control group(P<0.05).The pulmonary function indexes in the observation group were higher than those in the control group 1 month after operation(P<0.05).CD3^+,CD4^+,CD4^+/CD8^+in the observation group were higher than those in the control group,and CD8^+was lower than that in the control group after operation(P<0.05).Conclusion:Thoracoscopic and laparoscopic Ivor-Lewis surgery for middle and lower esophageal cancer can reduce surgical trauma,reduce postoperative complications,reduce the influence on pulmonary function and immune function of patients,and is conducive to rapid recovery of
作者
郭孟刚
杨绪全
周海宁
朱允和
GUO Menggang;YANG Xuquan;ZHOU Haining;ZHU Yunhe(Department of Thoracic Surgery,the Central Hospital of Suining,Sichuan Suining 629000,China)
出处
《现代肿瘤医学》
CAS
2020年第23期4083-4087,共5页
Journal of Modern Oncology
基金
四川省医学会科研课题计划(编号:S15078)。
