• Pak J Med Sci · Mar 2020

    Influence of different kinds of surgical resection on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer.

    • Tao Zhang, Hai Jiang, Chen Yu Ming, Yan Wang, Deng Mao, and Yuan Fu Wei.
    • Tao Zhang, Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China, P.R. 442000.
    • Pak J Med Sci. 2020 Mar 1; 36 (3): 532-537.

    ObjectiveTo investigate the effects of two kinds of surgical resection schemes, a conventional open surgical scheme and a thoracolaparoscopic esophagectomy surgical scheme, on operation-related clinical indexes, inflammatory cytokines and complications in elderly patients with esophageal cancer.MethodsA total of 100 elderly patients with esophageal cancer seen in the Department of Cardiothoracic Vascular Surgery, Renmin Hospital, Hubei University of Medicine, from June 2014 to June 2016 were enrolled and randomly divided into two groups, including a control group (50 patients) with a conventional open surgical scheme and an observation group (50 patients) with a thoracolaparoscopic esophagectomy surgical scheme. The operation time, the amount of bleeding during the operation, the incision length, the number of lymph nodes dissected, the hospitalization time, the HAMA scores and HAMD scores before and after the operation, the PSQI scores, SF-36 scores and levels of PCT, CRP and IL-6 after the operation, the recurrence and metastasis rates and the mortality at follow-up and the incidence of related complications of both groups were compared.ResultsThe operation time, the amount of bleeding during the operation, the incision length and the hospitalization time in the observation group were significantly less than those in the control group (p<0.05). The number of lymph nodes dissected in the observation group was significantly higher than that in the control group (p<0.05). The HAMA scores and HAMD scores after the operation in the observation group were significantly lower than those in the control group and those before the operation (p<0.05). The PSQI scores and SF-36 scores after the operation in the observation group were significantly better than those in the control group and those before the operation (p<0.05). The levels of PCT, CRP and IL-6 after the operation in the observation group were significantly lower than those in the control group (p<0.05). The recurrence and metastasis rates at follow-up in the observation group were significantly lower than those in the control group (p<0.05). There was no significant difference in mortality at follow-up between the two groups (p>0.05). The complication incidence after the operation in the observation group was significantly lower than that in the control group (p<0.05).ConclusionCompared with a conventional open surgical scheme, the thoracolaparoscopic esophagectomy surgical scheme possesses advantages in the treatment of elderly patients with esophageal cancer, including being a minimally invasive, simple operation, having a shorter recovery time, effectively relieving negative emotions, improving the quality of life, reducing the levels of inflammatory molecules and reducing the risk of related complications.Copyright: © Pakistan Journal of Medical Sciences.

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