微创Mckeown术治疗食管癌的临床效果、并发症观察及对其生命质量的影响

目的:分析微创Mckeown术治疗食管癌的效果、并发症及对患者生命质量的影响.方法:回顾性分析2013年1月~2016年6月我院收治的60例食管癌患者的临床资料,按手术方式分为A组(胸腹腔镜联合Mckeown术,n=32)与B组(左胸入路食管切除术,n=28),比较两组手术情况、术后疼痛程度、手术并发症发生率,两组均随访6个月,比较其复发率及生命质量的改善情况.结果:①A组术中出血量低于B组,其引流时间、住院时间均短于B组,淋巴结清扫数目多于B组,对比差异有统计学意义.②A组术后不同时间点VAS评分均低于B组,对比差异有统计学意义.③A组各并发症发生率均略低于B组,但仅吻合口瘘、喉返神经损伤比较差异有统计学意义.④两组术后复发率比较差异无统计学意义,但A组术后3、6个月生命质量评分均高于B组.结论:在食管癌患者的临床治疗中,采用微创Mckeown术疗效肯定,可行性强,安全性高,可减少患者术中出血量,缩短术后引流、住院时间,提高淋巴结清扫的彻底性,减轻患者术后疼痛程度,降低并发症发生率,有助于提升患者生命质量.

The clinical effect and complications of minimally invasive Mckeown surgery in the treatment of esophageal carcinoma and the effect on quality of life of patients

Objective To analyze the clinical effect and complications of minimally invasive Mckeown surgery in the treat-ment of esophageal carcinoma and the effect on quality of life of patients. Methods The clinical data of 60 cases of patients with esophageal carcinoma treated in our hospital from January 2013 to June 2016 were retrospectively analyzed. According to the surgical methods, the patients were divided into A group (treated by thoracoscopic and laparoscopic Mckeown surgery, n=32) and B group (treated by left thoracic approach esophagectomy, n=28). The condition of surgery, pain after surgery and the in-cidence of surgical complications were compared between the two groups. Both groups were followed up for 6 months, and the recurrence rate and the improvement of quality of life were compared between the two groups. Results ①The blood loss of A group during surgery was less than that of B group, the drainage time and hospitalization time were shorter than those of B group, and the number of dissected lymph nodes was larger than that in B group. ②The VAS scores of A group at different time points after surgery were lower than those of B group. ③The incidence of complications in A group was slightly lower than that in B group, but there were significant differences only in the incidence rates of anastomotic fistula and recurrent laryngeal nerve in-jury. ④There was no significant difference in recurrence rate between the two groups after surgery.3 and 6 months after surgery, quality of life scores of A group were higher than those of B group. Conclusion Minimally invasive Mckeown surgery is effec-tive, feasible and safe in the clinical treatment of patients with esophageal carcinoma. It can reduce the blood loss after surgery, shorten drainage time and hospitalization time, improve complete dissection of lymph nodes, reduce the pain degree of patients and reduce the incidence of complications, which can help to improve the quality of life of patients.