title: [Influence of pulmonary function after combined thoracoscopic and laparoscopic esophagectomy for the treatment of esophageal carcinoma].
abstract: OBJECTIVE
  To investigate the influence of combined thoracoscopic and laparoscopic esophagectomy for early postoperative pulmonary function, and to study the relative factors for postoperative pulmonary complications.
  
  
  METHODS
  From September 2009 to December 2010, 61 patients with esophageal cancer had undergone esophagectomy surgery, of which 32 patients had undergone combined thoracoscopic and laparoscopic esophagectomy (CTLE group), and 29 patients had undergone open three-field esophagectomy (open group). Pulmonary function, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)) were measured on the 1(th) preoperative day, 5(th) and 10(th) postoperative day, and arterial blood gas analyses were performed during the same period. Meanwhile, pain scores and other potentially relevant factors were recorded as well.
  
  
  RESULTS
  Preoperative pulmonary function and arterial blood gas analysis, including FEV(1)%, FVC%, PaO2 in two groups had no significant difference (t = -1.608 to 0.709, P = 0.113 to 0.481). On the 10(th) postoperative day, FEV(1)%, FVC%, PaO2, and SaO2 of two groups were significantly different (FEV(1)%: 77% ± 17% vs. 53% ± 13%, t = 6.241, P = 0.000; FVC%: 78% ± 13% vs. 57% ± 16%, t = 5.549, P = 0.000; PaO2: (87 ± 9) mmHg vs. (79 ± 14) mmHg, t = 2.477, P = 0.017; SaO2: 96% ± 3% vs. 94% ± 2%, t = 2.313, P = 0.024; 1 mmHg = 0.133 kPa). Pain score of CTLE group was lower than open group, and the scores of two groups had significant difference before the 5(th) day after surgery (t = -4.398 to -1.815, P = 0.000 to 0.049). Postoperative pulmonary complications of CTLE group was lower than open group (6/32 vs. 12/29, χ(2) = 3.745, P = 0.049).
  
  
  CONCLUSIONS
  Combined thoracoscopic and laparoscopic esophagectomy has advantages on early postoperative pulmonary function. It can relatively reduce the incidence of pulmonary complications after surgery.
authors.affiliation: Department of Thoracic Surgery, Taizhou Hospital, Taizhou, Zhejiang Province 317000, China.
authors.forename: Bao-fu
authors.initials: BF
authors.lastname: Chen
authors.forename: Min
authors.initials: M
authors.lastname: Kong
authors.forename: Cheng-chu
authors.initials: CC
authors.lastname: Zhu
authors.forename: Zhong-rui
authors.initials: ZR
authors.lastname: Ye
authors.forename: Min-hua
authors.initials: MH
authors.lastname: Ye
authors.forename: Cai-yun
authors.initials: CY
authors.lastname: Chen
authors.forename: Li-min
authors.initials: LM
authors.lastname: Jia
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Jia-hong
authors.initials: JH
authors.lastname: Ye
mesh_terms: D000368:Aged; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D012129:Respiratory Function Tests; D013906:Thoracoscopy