Comparison Of Short-term Clinical Efficacy Of Minimally Invasive Thoracic Laparoscopy And Traditional Open Mckeown Surgery In The Treatment Of Esophageal Cancer

Objective:China is a high incidence region for esophageal cancer.In the early stage of esophageal cancer,the majority of patients do not show clear clinical symptoms,patients in the hospital,most are in the advanced stages of the disease.Timely treatment of diagnosed patients can improve prognosis and quality of life.Surgery is still the main treatment for esophageal cancer.Traditional open Mckeown surgery has high trauma,high risk,multiple complications,and a high requirement for patients with their own conditions.With the development of endoscopic technique in clinical medicine,thoracoscope combined with minimally invasive Mckeown surgery has become a more mature surgical method.The purpose of this study was to investigate the advantages of thoracoscope combined with minimally invasive Mckeown surgery in the treatment of esophageal cancer compared to traditional open Mckeown surgery.Methods:Collection of anhui chaohu hospital affiliated to medical university in January2017-January 2022 cases of esophageal cancer patients admitted in thoracic surgery,according to include and exclude criteria to determine eventually into the group of 150 cases of patients,including 75 cases of laparoscopic combined minimally invasive thoracic Mckeown surgery as the observation group,75 cases of traditional open surgery Mckeown as control group.Retrospective analysis was performed on gender,age,smoking history,alcohol consumption history,body mass index,tumor stage,family history,lung function test of the observation group and control group,and a comparison was made between the perioperative clinical indicators of the two surgical methods,including: The operation time,intraoperative blood loss,postoperative drainage volume,number of lymph node dissection,pain score at 24 hours after operation,chest tube indwelling time,hospital stay,postoperative inflammatory indicators,incidence of postoperative complications(pulmonary infection,respiratory failure,anastomotic leakage,arrhythmia,chylothorax,hoarseness).Results : There was no significant statistical difference between the two groups in gender,age,smoking history,drinking history,body mass index,tumor stage,family history,and lung function test(P >0.05),and data from clinical trials were comparable.Compared with the traditional open Mckeown surgery,the intraoperative blood loss and postoperative drainage volume were significantly reduced by thoracic laparoscopy combined with minimally invasive Mckeown surgery,the postoperative pulmonary infection rate,the postoperative pain score 24 h,the postoperative thoracic tube indindent time were significantly reduced,and the postoperative inflammatory indicators were decreased.Furthermore,more lymph nodes were dissected than in traditional open surgery,and the difference was statistically significant(P < 0.05).However,there were no significant differences in operation time,hospital stay,hoarseness incidence,the incidence of respiratory failure,anastomotic fistula incidence and arrhythmia incidence between the two groups(P > 0.05).Conclusions : Chest laparoscopy combined with minimally invasive surgery can complete esophageal and gastric dissociation and lymph node dissection by small incision with energy apparatus and endoscopic apparatus under magnified and clear display.Surgeons have a clearer vision of the area during the operation,which can be used to better operate and effectively avoid unnecessary injuries.By comparing the clinical data of two groups of patients,it can be concluded that laparoscopic thoracic combined minimally invasive Mckeown surgery has the advantages of less bleeding,less pain,lower incidence of lung infection and more comprehensive lymph node dissection than traditional open Mckeown surgery for esophageal cancer.