A Comparative Study Of Single Port Inflatable Mediastinoscopy Combined With Laparoscopy And Mckeown In The Treatment Of Esophageal Cancer

Objective:To explore the surgical treatment effect and safety of a non-thoracic operation in the treatment of patients with esophageal cancer,that is,single port inflatable mediastinoscopy combined with laparoscopy.Methods:This retrospective study collected information on patients with esophageal cancer admitted to our hospital from March 1,2019 to December 31,2020.A total of 32 patients who underwent single-port inflatable mediastinoscopy combined with laparoscopic radical esophageal cancer were included.The patients were divided into group A,and 32 patients who underwent laparoscopic Mckeown operation in the same period were enrolled and divided into group B.Record the preoperative general baseline data of the two groups of patients,observe the postoperative indicators including surgical complications,chest tube and mediastinal duct drainage,operation time,postoperative hospital stay,related pathological results and lymph node dissection,and evaluate the postoperative pain scores of the patients,And perform statistical analysis.Result:There was a statistically significant difference between the two groups of patients with other underlying diseases(tuberculosis,pulmonary cysts,and bullae)before surgery(P<0.05);the single port inflatable mediastinoscopy combined with laparoscopy group(group A)had reduced postoperative Pulmonary infection is better than the laparoscopic Mckeown group(group B)(6.3% vs 25.0%,P=0.039);and the rate of postoperative lung air leakage is much lower than that of group B(0.0% vs 21.9%,P=0.016);Compared with group B in reducing pain on the 1st and 2nd day after surgery,group B performed better(8.17±2.88 vs 5.26±3.01,P=0.001)in terms of dissection of chest lymph nodes,especially It has a greater advantage in the removal of the right recurrent laryngeal nerve(27 vs 6,P=0.001).Conclusion:Single port inflatable mediastinoscopy combined with laparoscopic radical resection of esophageal cancer is a minimally invasive surgery method for non-thoracic esophageal cancer.Compared with the laparoscopic Mckeown group,the incidence of postoperative lung infections is lower,lung tissue damage is less,and postoperative pain is felt It is light,has the advantages of less trauma,safety and effectiveness.At present,this procedure is in the exploratory stage,and the existing long-term follow-up data have not yet formed an effective research result.It still needs to be further tested by clinical multi-center and large samples.In general,as a supplementary treatment method for minimally invasive treatment of esophageal cancer,this operation has a good development prospect and is worthy of clinical promotion.