关键词: 胸腔镜根治术, 颈部吻合, 食管癌, 疗效, 呼吸功能

Abstract: Objective To investigate the efficacy of thoracoscopic radical esophagectomy combined with left cervical anastomosis in the treatment of patients with esophageal cancer，and analyze its effect on the effect on the respiratory function of patients.
Methods 256 patients with esophageal cancer admitted to our hospital from January 2013 to January 2016 were enrolled，and divided into two groups according to their willingness.The thoracoscopic group （n=163） and the traditional group （n=93） received received thoracoscopic radical esophagectomy plus left cervical anastomosis and thoracic esophageal resection plus gastroesophageal intrathoracic anastomosis，respectively.Then the clinical efficacy was compared between the two groups.
Results The operation time of the thoracoscopy group was significantly longer than that of the traditional group，and the intraoperative blood loss was significantly less than the traditional group（both P<0.05）.There was no significant difference in the number of lymph node dissection between the two groups（P>0.05）.The postoperative pulse oximetry （SpO2） level in the thoracoscopy group was significantly higher than that in the traditional group，respiratory rate（RR） and minute ventilation （MV） level was significantly lower than the traditional group（both P<0.05）.The pain degrees showed a decreasing trend in both groups at the postoperative after 12h，24h，48h and 72h，with statistic difference between groups （P<0.05）.The total drainage volume in the thoracoscopic group was significantly less than that in the traditional group，and the recovery time of the right upper limb function，postoperative extubation time and postoperative hospital stay were significantly shorter than the traditional group（P<0.05）.The postoperative complication rate of the thoracoscopy group was significantly lower than the traditional group（P<0.05）.After 3 years of follow-up，the recurrence rate of esophageal cancer in both groups and mortality rate had no significant differences were observed between the two groups（P>0.05）.
Conclusion Application of thoracoscopic radical esophagectomy combined with left cervical anastomosis has the advantages of minimally invasive，can reduce the pain of the patients，and little impact on patitents’respiratory function，which is conducive to postoperative recovery and indicates no significant difference in the long-term prognosis.However，the operation is complex and the indications are limited，so it cannot completely replace open surgery.

Key words: thoracoscopic radical esophagectomy, cervical anastomosis, esophageal cancer, effect, respiratory function