关键词: 食管癌, 改良全腔镜术, 传统开放手术, 肺功能, 并发症

Abstract: Objective  To explore the effect of improved total cavity endoscopy on lung function,postoperative feeding and complications in patients with chronic lung disease of esophageal cancer. Methods  120 esophageal cancer patients with chronic lung disease admitted to our hospital from September 2022 to June 2023 were randomly divided into two groups.The observation group consisted of 60 patients who underwent improved total cavity endoscopy assisted esophageal cancer resection,while the control group consisted of 60 patients who underwent traditional open surgery.The perioperative related indexes,lung function indexes [forced expiratory volume in the first second (FEV-1),forced vital capacity (FVC),maximum ventilation volume (MVV)],inflammatory level [interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor (TNF-α)] were compared between the two groups.Results  The blood loss,operation time,number of lymph node dissection and drainage time in the observation group were (329.51±78.84)ml,(175.47±10.41)min,(29.67±17.86) pieces per case and (3.14±0.98) d respectively.In the control group,the intraoperative blood loss,operation time,number of lymph node dissection and drainage time were (372.31±99.23)ml,(148.54±10.68)min,(28.36±18.15) pieces and (6.37±1.23) d,respectively, there was statistical significance between the two groups (P<0.05).The FEV-1,FVC and MVV of the observation group were (1.88±0.53) L,(2.33±0.46) L and (32.59±11.84)L,respectively.Two weeks after operation,the control group was (1.37±0.31) L,(1.75±0.38) L and (23.68±9.41) L respectively, there was statistical significance between the two groups (P<0.05).The inflammatory factors IL-6,IL-8 and TNF-α in the observation group were (2.17±1.62)ng/ml,(2.09±1.52)ng/ml and (1.32±0.57) ng/ml,respectively.The control group were (3.06±1.52)ng/ml,(2.75±1.29)ng/ml and (1.73±0.75) ng/ml respectively, there was statistical significance between the two groups (P<0.05).The incidence of postoperative complications in the observation group and the control group were 6.67% and 20.00% respectively,and patients in the observation group ate earlier than those in the control group (P<0.05).Conclusion Compared with the traditional open surgery,the improved total laparoscopic surgery has the advantages of less trauma,simpler operation,less damage to lung function,significantly lower incidence of postoperative complications,and shorter postoperative eating time.

Key words: esophageal cancer, improved total cavity endoscopy, traditional open surgery, lung function, complication