关键词: 胃癌, 消化道重建, 双通道, 胆囊收缩功能, 营养状况

Abstract: [Abstract]  Objective  To analyze the effect of potential factors on the risk of respiratory failure after minimally invasive surgery for videoassisted thoracoscopic esophageal cancer.Methods   A total of 55 patients with respiratory failure after minimally invasive surgery for thoracic esophageal cancer were enrolled in the respiratory failure group.95 patients with no respiratory failure were included in the control group.The effects of gender，smoking，preoperative lung function（including MVV% and FEV1%），preoperative pulmonary comorbidities，preoperative hypoproteinemia，and operative time on the risk of respiratory failure were discussed.Statistical analysis data were performed using SPSS software，and single factor and multivariate logistic regression were used to analyze risk factors for respiratory failure after esophageal cancer surgery.Results   Univariate analysis showed that advanced age（≥70 years），smoking，preoperative pulmonary complication，operative time > 3h，postoperative anastomotic leakage，and chylothorax may be risk factors for respiratory failure.Preoperative maximum ventilation（MVV%）of group respiratory failure was 51.02±7.69 and the first second forced expiratory volume（FEV1%） was 39.05±6.47，which were lower than the control group（85.64±8.10，74.29±7.28，respectively，P<0.05）.Logistic multivariate regression analysis showed that age ≥ 70，operation time > 3h，low preoperative lung function and postoperative anastomotic fistula and chylothorax（B values of 1.313，1.345、1.489，1.579，1.574，respectively）were ndependent factors of respiratory failure after minimally invasive surgery for videoassisted thoracoscopic esophageal cancer（P<0.05）.Conclusion  Preoperative improvement of lung function，shortening operation time，reducing the incidence of postoperative anastomotic fistula and chylothorax which can help prevent postoperative respiratory failure.

Key words: gastric cancer, digestive tract reconstruction, dualchannel, gallbladder contraction, nutritional status