Clinical Efficacy Evaluation Of Video-assisted Thoracoscopic Combined With Endoscopic In The Treatment Of Esophageal Benign Tumors

Objective To discuss the effectiveness and safety of video-assisted thoracoscopic surgery combined with gastrointestinal endoscopy in the treatment of esophageal benign tumors,and to summarize the experience and application of video-assisted thoracoscopic surgery combined with minimally invasive endoscopic surgery in the treatment of benign esophageal tumors in our research center.Methods A retrospective analysis was performed on the clinical data of 26 patients with esophageal benign tumors who received minimally invasive surgical treatment with video-assisted thoracoscopy combined with gastrointestinal endoscopy in the thoracic surgery Department of Gansu Provincial Hospital from January2015 to October 2022.All patients were preliminatively diagnosed as esophageal benign tumors by endoscopic examination and chest imaging examination before surgery,and the tumor lesions were removed after surgical treatment and confirmed as esophageal benign tumors by histopathological examination and combined immunohistochemical staining.The basic information,lesion site,clinical manifestations,histopathological diagnosis,surgical treatment and postoperative follow-up results of patients were counted.To analyze the perioperative data,postoperative rehabilitation and complication rate of all patients with esophageal benign tumors who underwent video-assisted thoracoscopic surgery combined with gastrointestinal endoscopic treatment included in this study.Including one-time complete tumor resection rate,operation time,intraoperative blood loss,conversion to thoracotomy rate,postoperative thoracic drainage volume,postoperative drainage catheter indinduration time,postoperative pain evaluation,postoperative hospital stay,postoperative surgery-related complications and other perioperative indexes,and corresponding follow-up of patients.To evaluate the efficacy and safety of video-assisted thoracoscopic surgery combined with gastrointestinal endoscopy in the treatment of esophageal benign tumors.Results Among the 26 patients,17 were male and 9 were female;the mean body mass index(BMI)of all patients was(24.73±2.34)kg/m~2,and the mean age was(50.92±11.18)years.In terms of tumor site distribution,there were 3 benign tumors located in the upper esophagus,13 in the middle esophagus,and 10 in the lower esophagus.In terms of resected tumor diameter,the results showed that the average tumor length diameter(2.74±1.33)cm and the average tumor transverse diameter(1.88±0.96)cm were resected.11 patients showed difficulty in swallowing or choking after eating,3 patients showed chest pain,5 patients showed epigastric pain and discomfort,1 patient showed gastroesophageal reflux symptoms,and the remaining 6 patients did not have any symptoms,all of them were The remaining 6patients had no symptoms and were all seen during physical examination for submucosal bulging esophageal lesions.In terms of minimally invasive surgical treatment,the vast majority of patients successfully completed the surgery according to the preoperative designed surgical plan,with no residual lesions and no serious complications such as perioperative death.In terms of intraoperative open-heart surgery,there were no intraoperative open-heart surgery in 25 patients,and only one patient was converted to open-heart surgery due to intraoperative atrial fibrillation;all patients were successfully discharged from the hospital,and none of them had unplanned secondary surgery after surgery.In terms of operative time,the results of the study showed that the average operative operation time was(107.35±21.56)min,and in terms of intraoperative blood loss,the results showed that the average intraoperative blood loss of the patients was low at(68.62±29.79)m L.in terms of postoperative drainage indicators,the statistics showed that the average postoperative day 1 chest drainage for all patients was(186.35±55.36)m L,and the total postoperative chest drainage was(447.54±215.43)m L on average.Regarding the number of postoperative chest drain days,the study results showed that the average number of postoperative chest drain days for all patients was only(4.38±1.44)days.In terms of postoperative hospitalization time,the results of the study showed that the average postoperative hospitalization time of the patients was shorter,only(5.85±1.19)d.In terms of total hospitalization cost,the statistical data showed that the minimum hospitalization cost was 6123.76 yuan and the maximum hospitalization cost was 54,324.46 yuan,and the average total hospitalization cost was(30467.44±11,460.49)yuan.Regarding postoperative pain indicators,the results of the study showed that the mean VAS score for all patients was(3.23±0.99)in the 1st postoperative day;the mean VAS score for patients in the 2nd postoperative day was(2.65±1.16);and the mean VAS score in the 3rd postoperative day was(2.27±0.96).Regarding the additional use of analgesic pumps during the postoperative hospitalization,the statistics showed that patients pressed the analgesic pump less often on their own,with a mean of(2.8±0.84)times.All patients were followed up for a mean of(6.15±1.78)months after surgery,and all patients complained of better postoperative recovery and higher quality of life during the follow-up period,with no deaths occurring during the follow-up period.Conclusion video-assisted thoracoscopic surgery combined with gastrointestinal endoscopy for the treatment of esophageal benign tumors has higher safety and feasibility,less intraoperative damage to patients,higher safety,and is conducive to rapid postoperative recovery of patients,and has wide clinical application prospects.