充气式纵隔镜联合腹腔镜食管癌根治术治疗食管癌的临床效果OA

Objective To investigate the clinical efficacy of inflatable video-assisted mediastinoscopic transhiatal esophagectomy(IVMTE)in the treatment of esophageal cancer.Methods The clinical data of 82 patients with esophageal cancer admitted to our hospital from February 2023 to February 2025 were retrospectively analyzed.According to the surgical approach,they were divided into the study group(n=41)and the control group(n=41).The study group received IVMTE treatment,while the control group received thoracoscopic combined with laparoscopic esophagectomy(TLE)treatment.The perioperative indicators,levels of inflammatory factors,pulmonary function,complications,and postoperative recurrence were compared between the two groups.Results There was no significant statistical difference in the number of lymph nodes dissected between the two groups(P＞0.05).Compared with the control group,the study group had less intraoperative blood loss,lower drainage volume at 3 days after surgery,lower Visual Analogue Scale(VAS)score at 24 hours after surgery,as well as shorter operative time and hospital stay(P＜0.05).At 48 hours after surgery,the serum levels of interleukin(IL)-6,IL-8 and IL-10 in both groups were higher than those before surgery,while the above inflammatory indicators in the study group were significantly lower than those in the control group(P＜0.05).At 48 hours after surgery,the percentage of predicted forced vital capacity(FVC％),percentage of predicted forced expiratory volume in the first second(FEV1％)and percentage of predicted maximal voluntary ventilation(MVV％)in both groups decreased compared with preoperative levels;however,the above pulmonary function indicators in the study group were markedly higher than those in the control group(P＜0.05).The incidence of postoperative pulmonary infection in the study group was lower than that in the control group(P＜0.05).No significant differences were observed in the incidences of incision infection,anastomotic fistula,anastomotic stricture,hoarseness and tumor recurrence rate between the two groups(P＞0.05).Conclusions IVMTE yields equivalent clinical efficacy to TLE in the treatment of esophageal cancer.Compared with TLE,IVMTE has the advantages of slighter surgical trauma,milder inflammatory response,better pulmonary function protection,fewer pulmonary complications and faster postoperative recovery,and can effectively improve the perioperative safety and postoperative rehabilitation quality of patients,which is an ideal minimally invasive scheme for esophageal cancer and worthy of clinical promotion and application.