Influence of different kinds of?surgical resection on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer

摘要

Objective: To investigate the effects of two kinds of surgical resection schemes, a conventional opensurgical scheme and a thoracolaparoscopic esophagectomy surgical scheme, on operation-related clinicalindexes, inflammatory cytokines and complications in elderly patients with esophageal cancer.Methods: A total of 100 elderly patients with esophageal cancer seen in the Department of CardiothoracicVascular Surgery, Renmin Hospital, Hubei University of Medicine, from June 2014 to June 2016 wereenrolled and randomly divided into two groups, including a control group (50 patients) with a conventionalopen surgical scheme and an observation group (50 patients) with a thoracolaparoscopic esophagectomysurgical scheme. The operation time, the amount of bleeding during the operation, the incision length, thenumber of lymph nodes dissected, the hospitalization time, the HAMA scores and HAMD scores before andafter the operation, the PSQI scores, SF-36 scores and levels of PCT, CRP and IL-6 after the operation, therecurrence and metastasis rates and the mortality at follow-up and the incidence of related complicationsof both groups were compared.Results: The operation time, the amount of bleeding during the operation, the incision length and thehospitalization time in the observation group were significantly less than those in the control group(p0.05). The number of lymph nodes dissected in the observation group was significantly higher than thatin the control group (p0.05). The HAMA scores and HAMD scores after the operation in the observationgroup were significantly lower than those in the control group and those before the operation (p0.05). ThePSQI scores and SF-36 scores after the operation in the observation group were significantly better thanthose in the control group and those before the operation (p0.05). The levels of PCT, CRP and IL-6 afterthe operation in the observation group were significantly lower than those in the control group (p0.05).The recurrence and metastasis rates at follow-up in the observation group were significantly lower thanthose in the control group (p0.05). There was no significant difference in mortality at follow-up betweenthe two groups (p0.05). The complication incidence after the operation in the observation group wassignificantly lower than that in the control group (p0.05).Conclusion: Compared with a conventional open surgical scheme, the thoracolaparoscopic esophagectomysurgical scheme possesses advantages in the treatment of elderly patients with esophageal cancer, includingbeing a minimally invasive, simple operation, having a shorter recovery time, effectively relieving negativeemotions, improving the quality of life, reducing the levels of inflammatory molecules and reducing therisk of related complications.