全腔镜微创食管癌切除术治疗高龄食管癌患者的疗效研究

摘要

目的 评估全腔镜微创食管癌切除术治疗高龄(≥70岁)食管癌患者的可行性.方法 选择176例行胸腹腔镜微创食管癌切除术与胸腹部淋巴结清扫术的高龄食管癌患者(高龄组,n=176),依据临床分期配对选择528例非高龄的食管癌患者(非高龄组,n=528)进行对照.记录并比较两组患者的临床资料(包括术前心肺指标、术后并发症、住院时间及患者病死率等).结果 与非高龄组比较,高龄组高血压、心功能不全、肺功能不全与脑梗死发生率显著高于非高龄组,差异有统计学意义(P均＜0.05);高龄组患者术后肺部与和心脏并发症发生率显著高于非高龄组,差异有统计学意义(P均＜0.05).高龄组有1例患者死亡,非高龄组有5例患者死亡,两组患者病死率比较,差异未见统计学意义(P＞0.05).结论 全腔镜微创食管癌切除术具有解剖结构清晰、操作精细化和创伤小的优点,是高龄食管癌患者手术治疗的首选术式.%Objective To evaluate the feasibility of total endoscopic minimally invasive resection of esophageal carcinoma elderly patients with esophageal cancer (≥70 years).Methods One hundred and seventy-six elderly patients with esophageal carcinoma who underwent minimally invasive resection of esophageal carcinoma and thoracic and abdominal lymph node dissection (elderly group,n =176) were selected.According to clinical stages,528 non-elderly patients with esophageal cancer (non-elderly group,n =528) were selected.The clinical data,including preoperative cardiopulmonary parameters,postoperative complications,postoperative hospital stay and patient mortality were recorded and compared between the two groups.Results Compared with the patients of non-elderly group,the incidences of hypertension,cardiac dysfunction,pulmonary insufficiency and cerebral infarction were significantly higher in elderly group (P ＜ 0.05).The incidences of pulmonary complications and cardiac complications were significantly higher than those of the non-elderly group (P ＜ 0.05).One patient died in the elderly group and 5 cases died in the non-elderly group.There was no significant difference between the two groups in the mortality (P ＞ 0.05).Conclusions Total endoscopic minimally invasive resection of esophageal carcinoma has the advantages of clear anatomical structure,fine operation and less trauma,so it is the first choice of operation for elderly esophageal cancer patients.