管状胃经胸骨后路径与经食管床路径应用于胸腔镜联合食管癌手术对治疗成功率肺功能及术后并发症的影响

doi:10.3969/j.issn.1006-6233.2021.05.012

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Abstract Objective: To explore the effect of the trans-sternal route of tubular stomach and trans-esophageal bed route on the success rate, lung function and postoperative complications of thoracoscopic esophageal cancer surgery. Methods: From January 2019 to June 2020, 60 cases of thoracoscopic combined with esophageal cancer surgery in our hospital were selected and divided into esophageal bed pathway group and retrosternal pathway group according to the simple random number table method, with 30 cases in each group. The treatment success rate, indexes during operation, indexes of pulmonary function 24 hours after operation, postoperative complications and quality of life 7 days after operation were observed. Results: The patients of two groups were successfully completed the operation, the success rate was 100%. There was no death during the perioperative period. There was no statistical difference (P>0.05). There was no significant difference in operation time, intraoperative blood loss, length of hospital stay and indwelling time of drainage tube between the two groups (P>0.05). The gastrointestinal decompression fluid in the esophageal bed pathway group was significantly higher than that in the retrosternal pathway group (P<0.05). FVC and respiratory rate of the two groups were significantly improved after treatment (P<0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in anastomotic stenosis, pulmonary infection, arrhythmia and complications between the two groups (P>0.05), but the incidence of anastomotic leakage in the retrosternal pathway group was significantly higher than that in the esophageal bed pathway group (P<0.05). The difference between the two groups was statistically significant (P<0.05), or = e1.159 = 3.150, 95% confidence interval was (e0.174, e2.144) = (0.473, 5.828), suggesting that the incidence of acid reflux heartburn in the esophageal bed pathway group was significantly higher than that in the control group. The time difference was statistically significant (P<0.05), suggesting that the attack rate of patients at different time points had significant difference. The postoperative quality scores of the two groups were significantly improved (P<0.05), but there was no significant difference between the two groups (P>0.05). Conclusion: The results show that the tube stomach retrosternal path and transesophageal bed path had good effect in thoracoscopic combined with esophageal cancer surgery, with high success rate, strong safety, and help to improve the postoperative lung function and quality of life of patients. The former had relatively less gastrointestinal decompression fluid, higher probability of anastomotic leakage, and the latter had more serious gastrointestinal reflux, so it can be selected according to the specific situation Methods individualized treatment.

Key words： Esophageal cancer Retrosternal pathway Transesophageal bed route Complications Lung function

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	Articles by authors
	WANG Xingbang
	JIANG Pengpeng
	ZHU Siyu

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WANG Xingbang,JIANG Pengpeng,ZHU Siyu. Effect of Tube Stomach Retrosternal and Transesophageal Bed Pathways on the Success Rate Lung Function and Postoperative Complications of Thoracoscopic Combined with Esophageal Cancer Surgery[J]. HeBei Med, 2021, 27(5): 757-762.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.05.012 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I5/757

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