胸腔镜联合腹腔镜与食管切除术的疗效及术后感染危险因素分析
Efficacy of thoracoscopy combined with laparoscopy and esophagectomy and analysis of the risk factors for postoperative infection.
作者信息
Song Junding, Chu Fujuan, Zhou Wenjie, Huang Yi
机构信息
Department of Cardiothoracic Surgery, Zaozhuang Municipal Hospital Zaozhuang 277100, Shandong, China.
Department of Pharmacy, Zaozhuang Hospital of Traditional Chinese Medicine Zaozhuang 277000, Shandong, China.
出版信息
Am J Transl Res. 2022 Jan 15;14(1):355-363. eCollection 2022.
OBJECTIVE
To explore the efficacy of thoracoscopy combined with laparoscopy (TCL) and esophagectomy in patients with esophageal carcinoma (EC) and analyze the risk factors for postoperative infection.
METHODS
A total of 122 patients with EC admitted to our hospital were randomly divided into the study group (SG) and the control group (CG), with 61 patients in each group. Patients in the SG were treated with TCL, while patients in the CG were treated with traditional radical surgery for EC. The operation time, intraoperative blood loss, swallowing function, length of stay (LOS), number of lymph node dissections, postoperative infection rate, and quality of life in the first month after treatment were recorded and compared between the two groups. A logistic regression model was used to analyze the risk factors for postoperative infection.
RESULTS
The operation time, intraoperative blood loss, LOS, and postoperative infection rate of the SG were significantly lower than those of the CG (all <0.05). However, the number of lymph node dissections, swallowing function, and quality of life of patients in the SG were significantly higher than those in the CG, with statistically significant differences (all P<0.05). Postoperative hypoproteinemia, diabetes mellitus, and surgical mode were independent risk factors for postoperative infection in patients with EC (<0.05).
CONCLUSION
Compared with traditional radical surgery for EC, TCL and resection can effectively reduce trauma, improve the lymph node dissection rate, promote postoperative recovery, and reduce postoperative infection, which is worthy of clinical application and promotion. Hypoproteinemia, diabetes mellitus, and surgical procedures are independent risk factors for postoperative infection in patients with EC. However, with improved medical technologies, the attention to and understanding of these high-risk factors can effectively improve postoperative infection in EC patients.
目的
探讨胸腔镜联合腹腔镜（TCL）与食管癌切除术治疗食管癌（EC）患者的疗效，并分析术后感染的危险因素。
方法
将我院收治的122例EC患者随机分为研究组（SG）和对照组（CG），每组61例。SG组患者接受TCL治疗，而CG组患者接受EC传统根治性手术治疗。记录并比较两组患者的手术时间、术中出血量、吞咽功能、住院时间（LOS）、淋巴结清扫数量、术后感染率及治疗后第一个月的生活质量。采用逻辑回归模型分析术后感染的危险因素。
结果
SG组的手术时间、术中出血量、LOS及术后感染率均显著低于CG组（均<0.05）。然而，SG组患者的淋巴结清扫数量、吞咽功能及生活质量均显著高于CG组，差异具有统计学意义（均P<0.05）。术后低蛋白血症、糖尿病及手术方式是EC患者术后感染的独立危险因素（<0.05）。
结论
与EC传统根治性手术相比，TCL与切除术可有效减少创伤，提高淋巴结清扫率，促进术后恢复，降低术后感染，值得临床应用与推广。低蛋白血症、糖尿病及手术操作是EC患者术后感染的独立危险因素。然而，随着医疗技术的进步，对这些高危因素的关注与认识可有效改善EC患者的术后感染情况。
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