Clinical Analysis Of Minimally Invasive Esophagectomy

Objective:By comparing the intraoperative blood loss,the number of lymph node cleaning,the incidence of postoperative complications, the level of C-reactive protein and the indicators of immune function, to assess the effect of minimally invasive surgery on the body size,so as to provide a reference for the feasibility and safety of minimally invasive esophageal surgery.Methods:By analyzing the clinical data of 78 patients from the chest Second Department of Shanxi Tumor Hospital from June 2013 to September 2014.These patients aged60-79 years, and the preoperative gastroscopy as well as pathological examination were diagnosed with the middle or the lower thoracic esophageal squamous carcinoma, the imaging data found no signs of distant metastases,and all patients were not associated with other important organ dysfunction.Depending on the mode of operation,the patients were divided into minimally invasive group and open group,30 cases of minimally invasive group, 48 cases of open group.Finally,using statistical methods to contrast analysis the indicators of two groups of patients.Results:It is statistical analysis that the comparison of two groups of surgical lung infection rate, minimally invasive were 3.3%(1/30), and open group were 22.90%(11/48),P<0.05,it is show that the difference was statistically significant;Incidence of postoperative arrhythmia and anastomotic fistula in the two groups has no difference.The comparison of intraoperative blood loss, minimally invasive and open group, respectively(129.17±24.14)ml,(282.45±37.64)ml, P<0.05;In cleaning the number of lymph nodes by comparison, minimally invasive and open group,respectively(17.33±4.27),(11.69±5.11),P<0.05.The comparison of the indicators of immune function:The levels of CD8+7 days after operation in the minimally invasive group were markedly lower than those in the open group,the levels of CD4+/CD8+and NK cells 7 days after operation in the minimally invasive group were markedly higher than those in the open group. The levels of CD4+and CD4+/CD8+7days after operation in minimally invasive group notably decreased compared with before treatment. The levels of CD8+after operation in the open group conspicuously increased compared with before treatment, the levels of CD4+,CD4+/CD8+and natural killer cells( NK cells)7 days after operation in the open group conspicuously decreased compared with before treatment. The difference was statistically significant. The comparison of c-reactive protein:The indicator did not differ between the two groups in the preoperative 1 day, but the indicator in the postoperative 1 day and 5 days were higher than the level in the preoperative 1day,and the indicator in the postoperative 1 day and 5 days in the minimally invasive group was lower than that in the open group at the same time,(P<0.05). the difference was statistically significant.Conclusion:Compared with open surgery, There are many advantages of minimally invasive surgery of esophageal cancer.The incidence of postoperative complications is less than open surgery,and it also has certain advantages in the operation.Minimallyinvasive surgery has less trauma on the body, and the suppression of immune function is also less than open surgery.Minimally invasive surgery is worth promoting.