胸腹腔镜联合食管癌根治术对食管癌患者肺功能与生存率的影响

摘要

目的：探讨胸腹腔镜联合食管癌根治术对食管癌患者的肺功能与生存率的影响。方法选取2011年2月~2013年2月在我院行手术治疗食管癌患者70例，其中35例行胸腹腔镜联合食管癌根治术(腔镜组)，其余35例行开胸食管癌切除术(对照组)，比较两组患者术前及术后第5天、术后2个月的肺功能指标FEV1和FVC及两组患者术后6个月、术后1年的生存率、并发症情况。结果术后2个月，两组患者的FEV1、FVC均较术前及术后第5天显著升高，且腔镜组患者术后2个月的FEV1、FVC对照组显著升高(t=2.76、2.59，P<0.05)。腔镜组患者的生存率术后6个月、术后1年虽然分别高于对照组，但差异不显著(χ2=1.753、1.982，P>0.05)。术后腔镜组患者无一例出现房颤，其并发症发生率仅8.6%，而对照组1例出现房颤，其并发症发生率达28.6%，明显高于腔镜组，差异具有显著性(χ2=4.753，P<0.05)。结论胸腹腔镜联合食管癌根治术治疗食管癌效果好，有利于改善食管癌患者的肺功能，减少术后并发症的发生率，从而提高患者的生存率。%Objective To investigate the effects and the impact on lung function and survival rate of laparoscopic surgery combined thoracic for patients with esophageal carcinoma. Methods From February 2011 to February 2013 in our hospital,selected 70 cases patients with esophageal cancer, 35 patients took laparoscopic surgery combined tho-racic as laparoscopy group, and the remaining 35 patients took esophageal chest resection as control group , before and after surgery the first five days, lung function after two months of forced expiratory volume in 1 second (FEV1) and forced vital capacity(FVC)and two groups of patients undergoing after six months, one year survival rate after surgery, postoperative complication rate case were compared between two groups. Results After two months, the two groups of patients with FEV1, FVC significantly increased than before the surgery and the first five days after surgery, and the laparoscopic group patients of FEV1, FVC significantly higher than the control group, the difference was statistically significant(t=2.76,2.59, P<0.05). The survival rate of patients after endoscopic six months, respectively, after 1 year al-though higher, but the difference was not significant (χ2=1.753,1.982, P>0.05). None of the patients with postoperative atrial fibrillation laparoscopy group, the complication rate of only 8.6%, while the control group 1 patients had atrial fibrillation, the complication rate was 28.6%, was significantly higher than the laparoscopic group, the complications the incidence between two groups, the difference was statistically significant(χ2=4.753, P<0.05). Conclusion Laparoscopic surgery combined thoracic can help to improve lung function in patients with esophageal cancer , and reduce the inci-dence of postoperative complications, thereby improving patient survival .