胸腔镜与开胸手术方式对食管癌患者围术期单肺通气时Qs/Qt炎性因子淋巴结清扫的影响

doi:10.3969/j.issn.1006-6233.2020.07.005

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Abstract Objective: To investigate the effects of thoracoscopy and thoracotomy on Qs/Qt, inflammatory factors and lymph node dissection during perioperative one-lung ventilation in patients with esophageal cancer. Methods: 58 cases of esophageal carcinoma between July 2017 and October 2019 in our hospital were selected prospectively as the research object and divided on the patients’ own willingness into traditional thoracotomy group (the control group, 26 cases) and thoracoscope group (observation group,32 cases). Clinical indicators were collected, Qs/Qt at different time points of single lung ventilation was recorded, inflammatory factor levels were analyzed, and prognosis was observed. Results: Postoperative Qs/Qt levels of 2 groups of patients were significantly elevated at each point of time, and the difference was statistically significant (P<0.05); The same point of time comparison showed that in the observation group Qs/Qt levels of T1, T2 and T3 were (37.28±1.76) %, (44.91±2.57) %, (38.82±3.67) %, significantly higher than those of the control group (30.31±1.80) %, (37.60±3.01) %, (33.28±3.15) %, and the difference was statistically significant (P<0.05). The comparison of clinical indexes showed that blood loss and hospital stay of the observation group were (186.66±71.25)mL, (12.85±2.06)d, significantly lower than the control group (352.93±80.99) mL, (14.46±2.25) d, and the difference was statistically significant (P<0.05). Postoperative comparison showed that 2 d TNF-α, IL-8 levels in preoperative period and postoperative 2 d period were (37.59±11.31)pg/mL, (132.66±34.9) pg/mL, (13.98 ± 5.22)pg/mL, (91.27±28.96) pg/mL, significantly lower than control group (56.83±16.64) pg/mL, (189.63±56.86)pg/mL, (32.60±6.57) pg/mL, (161.28±34.65) pg/mL, and the difference was statistically significant (P<0.05). In addition, the operation time, the number of lymph nodes clearance, the incidence of complications and survival time had no statistically significant difference (P>0.05). Conclusion: Both thoracoscopy and laparotomy had similar effects on lymph node clearance, complications and survival time of esophageal cancer, but thoracoscopy had more advantages in shortening hospital stay and reducing inflammatory response, while the Qs/Qt level of single-lung ventilation during thoracotomy was lower.

Key words： Esophageal cancer Thoracoscopy Thoracotomy One-lung ventilation

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	ZHANG Biao
	LI Junqing
	GU Jiangkui

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ZHANG Biao,LI Junqing,GU Jiangkui. The Effects of Thoracoscopy and Thoracotomy on Qs/Qt Inflammatory Factors and Lymph Node Clearance During Perioperative One-lung Ventilation in Patients with Esophageal Cancer[J]. HeBei Med, 2020, 26(7): 1075-1078.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.07.005 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I7/1075

[1] 何静,陈瑞,何建明.食管癌术后单食管床引流管与胸腔、纵隔双管引流的应用效果比较[J].实用临床医药杂志,2019,23(11):46~48.
[2] Li M, Wan X, Wang Y, et al. Time trends of esophageal and gastric cancer mortality in China, 1991-2009: an age-period-cohort analysis[J]. Scientific Reports, 2017, 7(1):6797.
[3] Li S, Liu H, Diao C, et al. Prognosis of surgery combined with different adjuvant therapies in esophageal cancer treatment: a network meta-analysis[J]. Oncotarget, 2017, 8(22):36339~36353.
[4] 戎国祥,陈锁成,潘忠军.胸腔镜下食管癌手术治疗的近期临床效果分析[J].国际消化病杂志,2017,37(6):402~404.
[5] Primieri P, Ancona P, Gualtieri E. Unusual airways management during one-lung ventilation in thoracic surgery[J]. Saudi Journal of Anaesthesia, 2017, 11(2):225.
[6] Sardana R K, Chhikara N, Tanwar B, et al. Dietary impact on esophageal cancer in humans: a review[J]. Food & Function, 2018, 9(4):1967~1977.
[7] Yu C, Tang H, Guo Y, et al. Effect of hot tea consumption and its interactions with alcohol and tobacco use on the risk for esophageal cancer: a population-based cohort study[J]. Annals of Internal Medicine, 2018, 168(7):489~497.
[8] Schlottmann F, Strassle P D, Charles A G, et al. Esophageal cancer surgery:spontaneous centralization in the US contributed to reduce mortality without causing health disparities[J]. Annals of Surgical Oncology, 2018, 25(8):1~8.
[9] Zhao X, Fu J, Zhou X, et al. Successful one-lung ventilation using a bronchial blocker tube for a large tracheal carcinoma resection[J]. Journal of Clinical Anesthesia, 2017, 39(C):165~166.
[10] Tahan M R E, Pasin L, Marczin N, et al. Impact of low tidal volumes during one-lung ventilation. A meta-analysis of randomized controlled trials[J]. Journal of Cardiothoracic and Vascular Anesthesia, 2017, 31(5):1767.
[11] 鄂德琇,冶治,高哲俊,等.胸腔镜与传统手术对食管癌的临床疗效与术后体液及细胞免疫功能的影响[J].河北医学,2017,23(9):1433~1437.