Effects of thoracoscopy combined with laparoscopy on lung function and tumor micrometastasis in patients with thoracic esophageal cancer / 中华内分泌外科杂志

ABSTRACT

Objective:To investigate the effect of thoracoscopy combined with laparoscopy on lung function and tumor micrometastasis in patients with thoracic esophageal cancer.Methods:109 patients with thoracic esophageal cancer admitted from Mar. 2018 to Jul. 2019 in our hospital were divided into study group (60 cases) and the control group (49 cases) . The study group underwent thoracoscopy and laparoscopy assisted surgery, while the control group underwent traditional surgical resection of esophageal cancer. The differences of lung function, RBC immune function and the expression of invasive gene in the lesions between the two groups were compared.Results:Three days after the operation, maximum ventilation per minute (MVV) , forced expiratory volume for 1 s (FEV1) and vital capacity (VC) of the two groups were all decreased ( P<0.01) , but they were significantly higher in the study group than in the control group[ (69.90±7.07) vs (48.62±5.09) , (75.12±7.93) vs (42.99±4.81) , (74.57±7.30) vs (41.37±4.69) ( P<0.01) ]. mRNA of matrix metalloproteinase 9 (MMP9) and tumor necrosis factor receptor-related protein 1 (TRAP1) in the two groups were all decreased ( P<0.01) , while they were significantly higher in the study group than in the control group [ (0.54±0.09) vs (0.42±0.06) , (0.52±0.08) vs (0.41±0.06) ( P<0.01) ]. mRNA of Krüppel-like factor 4 (KLF4) and E-cad-herin in the two groups were all increased ( P<0.01) , while it was significantly lower in the study group than in the control group[ (2.87±0.30) vs (3.17±0.36) , (2.92±0.32) vs (3.19±0.38) ( P<0.01) ]. RBC immune complex rosette rate (RBC-ICR) in the study group was higher than that on the first day before operation ( P<0.01) , and gradually decreased from the first day after operation, and recovered to the preoperative level on the third day after operation. At the end of operation, red blood cell C3b receptor rosette rate (RBC-C3bRR) and red blood cell adhesion tumor cell rosette rate (TRR) in the study group were all decreased compared with those on the first day before operation ( P<0.01) , and gradually increased on the first day after operation in the study group, and recovered to the preoperative level on the third day after operation. Except for the first day before surgery, there were statistically significant differences in red blood cell immune function indexes at other time points between the study group and the control group[At the end of the operation (30.29±4.80) vs (34.68±5.47) , (16.02±1.58) vs (12.03±1.17) , (17.50±2.86) vs (12.59±2.26) ; 1 d after operation (29.13±4.19) vs (35.01±5.29) , (20.98±2.86) vs (16.23±2.40) , (22.50±2.56) vs (17.39±2.34) ; 3 d after operation (26.01±3.80) vs (31.50±5.01) , (23.30±3.37) vs (18.02±2.79) , (25.80±2.10) vs (21.19±2.60) ( P<0.01) ]. Conclusion:In patients who need radical surgery for thoracic esophageal cancer, the application of thoracoscopy combined with laparoscopy has little effect on lung function, red blood cell immunity, and tumor micrometastasis, which is worth promoting.