关键词: 老年人, 食管癌, 胸腔镜, 支气管封堵器, 人工气胸

Abstract: Objective To investigate the application of artificial pneumothorax and endobronchial blocker in thoracoscopic McKeown surgery for mid-lower esophageal carcinoma and the effect on perioperative complications. Methods A total of 102 patients with middle-lower section esophageal cancer were randomly divided into the artificial pneumothorax group (AP group, n=50) and the bronchial blockade group (BB group, n=52). Lung collapse scores, chest operation time, chest blood loss, operation time, extubation time, number of thoracic lymph nodes dissected, cases of recurrent laryngeal nerve injury, cases of perioperative arrhythmia, postoperative delirium and incidence of pulmonary complications were recorded and compared between the two groups. Results There were no significant difference between the two groups in the amount of thoracic hemorrhage, the number of dissected lymph node, the operation time, the number of thoracic lymph rodes dissected, and cases of recurrent laryngeal nerve injury (P >0.05). Compared with AP group, BB group had lower lung collapse score (P<0.05), shorter thoracic operation time and extubation time (P<0.05), and lower incidence of perioperative arrhythmias, pulmonary complications and postoperative delirium (P<0.05). Conclusions Compared with artificial pneumothorax, bronchial blockers can provide better exposure to the operative field, reduce the incidence of perioperative arrhythmia and postoperative pulmonary complications, and can be used as the preferred airway management method for thoracoscopic McKeown surgery for the elderly patients with middle-lower esophageal cancer under indications.

Key words: aged, esophageal cancer, thoracoscopic, bronchial blocker, artificial pneumothorax