A Comparative Study On The Short-Term Clinical Effect Of Thoracoscopic And Tracheostomy Esophagectomy With Gastric Tubular Anastomosis

Objective By comparing the clinical data of thoracoscopic esophagogastrostomy and thoracotomy esophagogastrostomy,to study the relevant data and postoperative complications between the two groups,so as to explore the application value of thoracoscopic esophagogastrostomy.Methods A retrospective analysis was conducted on 248 complete cases of "radical resection of esophageal carcinoma + esophageal-tubular stomachic anastomosis" performed in the Tumor Hospital Of Ningxia Medical University on January 1,2010 to December 31,2017(248 cases).Among them,100 cases of "thoracoscopic esophagectomy" were experimental group,148 cases of "thoracotomy esophagectomy" were control group,the incidence of pulmonary infection,anastomotic leakage and arrhythmia were analyzed.Measurement data were expressed as mean(x?)± standard deviation(s),and a t-test was used for comparison between groups.The enumeration data were represented by the number of cases and percentages,and the comparison between groups was analyzed by the chi-square test.P<0.05(α=0.05)was considered statistically significant.Results After inclusion in the exclusion criteria,248 complete cases were included in the study,and data statistics were carried out.Among them,203 cases were male(81.9%)and 45 cases were female(18.1%);The average age was 61.40 years old,the majority of patients aged 50 to 65 years old,accounting for 53.2%;The proportion of patients with "thoracotomy esophagectomy was 59.7%;16.65 ± 3.713 days after operation;Most of the patients were located in the middle of the chest,accounting for 66.5%.Pulmonary infection is the most common complication after operation 15.7% The proportion of patients with anastomotic leakage 4.4%,perioperative death Three Example,proportion 1.2%.There was no significant difference in gender,age,smoking history,previous history,tumor location and tumor stage between the two groups(P > 0.05);The operation time of thoracoscopy group was significantly higher than that of thoracotomy group(P < 0.05);The level of serum albumin in thoracoscopic group was higher than that in thoracotomy group(P < 0.05);The number of lymph nodes in thoracic cavity in thoracoscopic group was higher than that in thoracoscopic group(P < 0.05);The days of hospitalization after surgery in the thoracoscopic group were less than those in the open chest group(P < 0.05);The incidence of pulmonary infection in the thoracoscopic group was lower than that in the thoracotomy group(P < 0.05),and there was no significant difference in other postoperative complications(P > 0.05).Conclusion 1.Thoracoscopic esophagectomy has the same safety as thoracotomy esophagectomy,and the number of lymph nodes in the chest,the average level of human albumin and the postoperative hospital stay are better than open resection of esophageal cancer.2.Thoracoscopic esophagectomy does not increase the risk of anastomotic leakage and arrhythmia,and it can effectively reduce the incidence of postoperative pulmonary infection.