关键词: 食管癌；胸腔镜；食管胃吻合口漏；血管内皮生长因子；胰岛素样生长因子-1

Abstract: Objective To investigate the relationship between serum levels of vascular endothelial growth factor (VEGF) and insulin-like growth factor 1 (IGF-1) and esophagogastric anastomotic fistula after thoracoscopic radical resection of esophageal cancer.Methods 425 patients with esophageal cancer treated in our hospital from September 2015 to September 2022 were selected and divided into anastomotic fistula group (31 cases) and non-anastomotic fistula group (394 cases) according to the postoperative esophagogastric anastomotic fistula.Serum VEGF and IGF-1 levels were detected to analyze the risk factors affecting the occurrence of esophagogastric anastomotic fistula after thoracoscopic esophageal cancer surgery and the value of VEGF and IGF-1 in predicting the occurrence of esophagogastric anastomotic fistula after thoracoscopic esophageal cancer surgery.Results The serum levels of VEGF and IGF-1 in anastomotic fistula group decreased gradually after operation,while the serum levels of VEGF and IGF-1 in non-anastomotic fistula group increased gradually.The levels of serum VEGF and IGF-1 before,1 day after,2 day after and 3 day after anastomotic fistula group were lower than those of the group without anastomotic fistula (P<0.05).Postoperative pulmonary infection,hypoalbumin，postoperative 3 d VEGF and postoperative 3 d IGF-1 were associated with esophagogastric anastomotic fistula after thoracoscopic esophageal cancer (P<0.05).Postoperative 3 d VEGF and postoperative 3 d IGF-1 predicted the area under the curve of esophagogastric anastomosis fistula after thoracoscopic surgery for esophageal cancer was 0.675 and 0.655,and the area under the curve of the combined two indexes was 0.841,which was higher than the single index (Delong z=3.752,3.218,P<0.05).Conclusion The serum levels of VEGF and IGF-1 decreased in patients with anastomotic fistula after thoracoscopic radical resection of esophageal cancer,which was closely related to the occurrence of anastomotic fistula.

Key words: esophageal cancer; thoracoscope; esophagogastric anastomotic fistula; vascular endothelial growth factor; insulin-like growth factor-1