关键词: 食管肿瘤, 结核,肺, 消化系统外科手术, 对比研究, 治疗结果

Abstract:

Objective To investigate the feasibility and safety of surgical treatment for patients who have stable pulmonary tuberculosis associated with lower Methods The clinical data of surgical treatment for 34 cases of stable pulmonary tuberculosis associated with lower esophageal carcinoma (Group A) and 310 cases of lower esophageal carcinoma alone (Group B) from March 2009 to March 2014 in Taian Tumor (Tuberculosis) Hospital was collected. All the patients received routine surgical treatment for lower esophageal carcinoma. The difference between both groups in operation lasting time, blood loss, resection rate, postoperative hypoxemia, delayed fever, cardiac arrhythmia, pulmonary complications, wound healing, anastomotic leakage, operative mortality and survival rate was retrospectively analyzed. DPS 10.0 was used for statistical analysis. The measurement data was expressed as “ \bar{x} ±s”, and t test was used. The count data was small sample data, and the corrected χ ² test was used. P<0.05 was regarded as statistically significant. Results There was no statistically difference (P>0.05) between the two groups in operation lasting time (A: (3.4±0.4)h, B: (3.1±0.4)h. t=1.77, P=0.055), intraoperative blood loss (A: (181.0±71.4)ml, B: (165.0±80.5)ml. t=0.73, P=0.241) and the resection rate (A: 94.1% (32/34), B:93.5% (290/310). χ ²=0.06, P=0.810). The incidence rate of postoperative hypoxemia (17.6%, 6/34), surgical delayed fever (32.4%, 11/34) and pulmonary complications (23.5%, 8/34) in Group A was significantly higher than that in Group B (6.5%, 20/310; 16.1%, 50/310; 10.3%, 32/310) (χ ²=4.01, P=0.045; χ ²=4.47, P=0.034; χ ²=3.99, P=0.045); but there was no statistically difference (P>0.05) between the two groups in the incidence rate of cardiac arrhythmia (A: 8.8% (3/34), B: 6.1% (19/310); χ ²=0.06, P=0.810), difficult healing wound (A: 2.9% (1/34), B: 2.9% (9/310); χ ²=0.28, P=0.599), anastomotic leakage rate (A: 5.9% (2/34), B: 3.9%(12/310); χ ²=0.01, P=0.915), and operative mortality (A: 2.9% (1/34), B: 1.0% (3/310); χ ²=0.03, P=0.860). There was no significant difference between the two groups in 1-year survival rate (A: 94.1% (32/34), B: 93.9% (291/310); χ ²=0.10, P=0.748) and 2-year survival rate (A: 67.7% (23/34), B: 74.8% (232/310); χ ²=0.49, P=0.482), but the 3-year survival rate in Group A was significantly lower than that in Group B (A: 20.6% (7/34), B: 42.9% (133/310); χ ²=5.43, P=0.019). No postoperative progression and dissemination of tuberculosis were found in Group A. Conclusion The feasibility and safety of surgical treatment for patients who have stable pulmonary tuberculosis associated with lower esophageal carcinoma are good, and there is no progression and dissemination of tuberculosis, suggesting that surgical treatment is still the primary and effective treatment for these patients.

Key words: Esophageal neoplasms, Tuberculosis,pulmonary, Digestive system surgical procedures, Comparative study, Treatment outcome