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胸腹腔镜与传统开胸手术对食管癌患者术后炎症因子的影响
Effect of minimally invasive esphagectomy
vs open esophagectomy on post-operative cytokines in esophageal cancer patients- 第三军医大学学报 2017年39卷第23期 页码：2303-2306
- 作者机构：
1.400011 重庆，重庆医科大学附属第一医院胸心外科
2.400013 重庆，重庆市人民医院胸外科
- 作者简介：
[王睿，E-mail：53123298@qq.com WANG Rui, E-mail: 53123298@qq.com
- 基金信息：重庆市卫生局医学科研面上项目(20132110)
DOI：10.16016/j.1000-5404.201707146
中图分类号： R392.11;R730.56;R735.1收稿：2017-07-28，
修回：2017-10-08，
纸质出版：2017-12-15
- 稿件说明：
移动端阅览
卿瑞辰, 王睿, 陈焕文, 等. 胸腹腔镜与传统开胸手术对食管癌患者术后炎症因子的影响[J]. 第三军医大学学报, 2017,39(23):2303-2306.
Ruichen QING, Rui WANG, Huanwen CHEN, et al. Effect of minimally invasive esphagectomy
vs open esophagectomy on post-operative cytokines in esophageal cancer patients[J]. Journal of Third Military Medical University, 2017, 39(23): 2303-2306.卿瑞辰, 王睿, 陈焕文, 等. 胸腹腔镜与传统开胸手术对食管癌患者术后炎症因子的影响[J]. 第三军医大学学报, 2017,39(23):2303-2306. DOI： 10.16016/j.1000-5404.201707146.
Ruichen QING, Rui WANG, Huanwen CHEN, et al. Effect of minimally invasive esphagectomy
vs open esophagectomy on post-operative cytokines in esophageal cancer patients[J]. Journal of Third Military Medical University, 2017, 39(23): 2303-2306. DOI： 10.16016/j.1000-5404.201707146.
摘要
目的
2
对比研究胸腹腔镜手术(minimally invasive esphagectomy
MIE)与传统开胸手术(open esophagectomy
OE)食管癌患者术后炎症因子水平的变化，探讨两种手术方法引起炎性反应的差异。
方法
2
选取2015年11月至2016年3月重庆医科大学附属第一医院胸心外科符合研究标准的食管癌患者共28例(MIE组及OE组各14例)，采集患者术前和术后6、12、24、48 h血液样本。采用ELISA测定血清细胞因子内皮素(endothelin
ET)、白细胞介素-8(interleukin-8，IL-8)、白细胞介素-10(IL-10)及肿瘤坏死因子α(tumour necrosis factor α
TNF-α)水平。
结果
2
OE组中位年龄为67.5岁，MIE组中位年龄为61岁，两组患者一般资料及手术时间
差异无统计学意义(
P
>
0.05)。与OE组比较，MIE组术中出血量、术后入ICU时间、术后留院时间及肺部感染例数差异均有统计学意义(
P
<
0.05)。术后第6、12、24小时血清IL-8水平，术后第6、12小时血清TNF-α水平，术后各时间点血清IL-10水平差异均有统计学意义(
P
<
0.05)。
结论
2
与传统开胸手术比较，胸腹腔镜手术治疗食管癌引起的炎症反应程度相对较轻，更有利于患者术后恢复。
Abstract
Objective
2
To observe the dynamic changes of post-operative cytokine levels in esophageal cancer patients after minimally invasive esophagectomy (MIE) and open esophagectomy (OE)
and investigate the discrepancy of inflammatory response between the 2 approaches.
Methods
2
A total of 28 esophageal cancer patients admitted in the First Affiliated Hospital of Chongqing Medical University from November 2015 to March 2016 were prospectively recruited in this study. They were divided into 2 groups (
n
=14 for each group)
undergoing MIE (MIE group) and OE (OE group) respectively. The blood samples were collected before and at 6
12
24 and 48 h after operation. Double-antibody sandwich ELISA were applied to detect serum levels of endothelin (ET)
interleukin-8 (IL-8)
IL-10 and tumor necrosis factor α (TNF-α)
respectively.
Results
2
The median age was 67.5 years in the OE group
and 61 years in the MIE group. There were no significant differences between the 2 groups in preoperative clinical data and operative times (
P
>
0.05). The MIE group had less amount of median intraoperative blood loss
shorter median length of ICU stay
shorter median length of postoperative hospital stay and lower incidence of postoperative pulmonary complication (all
P
<
0.05) when compared with the OE group. Significant differences were also seen in the serum levels of IL-8 at 6
12 and 24 h postoperatively
and TNF-α levels at 6 and 12 h postoperatively
as well as IL-10 at each postoperative time points between the 2 groups (
P
<
0.05).
Conclusions
2
Compared with OE
MIE causes milder inflammatory responses
and is beneficial to postoperative recovery in esophageal cancer patients.
关键词
Keywords
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