RÉSUMÉ
Objective To compare the incidence of perioperative complications and the degree of traumatic stress reaction between thoracoscopic radical esophagectomy and open radical esophagectomy for esophageal cancer.Methods 97 patients with esophageal cancer in our hospital were divided into group A (thoracoscopic esophagectomy,n =51) and group B (open esophagectomy,n =46) according to the operation method.The group A was given thoracoscopic radical resection of esophageal cancer,while the group B was given open radical resection of esophageal cancer.The operative indexes (intraoperative blood loss,intraoperative fluid volume,operative time,incision length),the incidence rate of perioperative complications,body traumatic stress response indexes [white blood cell count (WBC),serum C-reactive protein (CRP),free thyroxine (FT4)] and tumor markers [squamous cell carcinoma antigen (SCC),carbohydrate antigen 125 (CA125)] were compared between the two groups.Results The group A had less intraoperative blood loss,intraoperative fluid volume and shorter operative time and incision length compare with group B (P ≤ 0.05).The incidence rate of perioperative complications in group A was lower than that in group B (17.65％ vs 36.96％) (P ≤ 0.05).There was no significant difference in the levels of WBC,CRP and FT4 between the two groups at the same time (P ＞ 0.05),so as the levels of SCC and CA125 (P ＞ 0.05).Conclusions Compared with open radical esophagectomy,the thoracoscopic esophagectomy had lower incidence of perioperative complications,but there was no significant difference in the degree of traumatic stress reaction between the two methods.
RÉSUMÉ
Objective To investigate the clinical effect of thick drainage tube thoracic closed drainage assisted by thin drainage tube after esophagectomy. Methods A total of 112 patients who received esophagectomy in the Department of Thoracic Surgery of Shanxi Dayi Hospital from January 2014 to December 2017 were retrospectively analyzed. The patients were divided into the test group (60 patients) and the control group (52 patients). The test group used thick tube in thoracic close drainage assisted by thin drainage tube, and the control group took general thoracic closed drainage. The operation time, the bleeding of operation, the number of lymph node dissection, the number of post-operative complications, the hospitalization time after operation, postoperative fever time, the frequency of post-operative puncture in both groups were observed. The post-operative pain was evaluated by using visual analogue score (VAS). Results There were no statistical differences in the time of operation [(4.3±1.3) h vs. (4.5±0.9) h], bleeding of operation [(137±21) ml vs. (141±21) ml], the number of lymph node dissection [(18.5±5.2) vs. (17.2±2.4)] and the number of post-operative complications (11 cases vs. 7 cases) between the test group and the control group (all P>0.05). There were statistical differences in the hospitalization time after surgery [(14.9±2.4) d vs. (20.5 ±3.2) d], post-operative fever days [(5.8 ±1.4) d vs. (7.4 ±1.4) d] and the frequency of post-operative puncture (7 vs. 13) between the test group and the control group (all P< 0.05). And there were statistical differences in the VAS scores for post-operative resting and coughing from 48 h to 72 h (all P< 0.05). Conclusion The thin drainage tube is more effective in assisting thoracic closed drainage after esophagectomy. It can reduce post-operative pain and shorten the length of hospitalization, which is worthy of further promotion.