右開胸食道癌手術後における気管後壁膜様部の呼吸性運動の変化 肺癌手術との比較

Abstract

Movement of the membranous part of the posterior tracheal wall on respiration was investigated in the early and late postoperative periods in 5 patients undergoing one-stage radical operation for esophageal cancer (esophagectomy and reconstruction performed at one time), 4 patients undergoing two-stage radical operation for esophageal cancer, and 4 patients undergoing radical operation for right lung cancer. The movement of the posterior tracheal wall was represented by the percentage of the difference between the maximal and minimal values of the anteroposterior diameter of the trachea to the minimal value of the anteroposterior diameter of the trachea. In all cases, the anteroposterior diameter of the trachea was maximal at the end of inspiration and minimal at the end of expiration. Fluctuations of movement in quiet breathing in the early period after operation for esophageal cancer were 16±5% and 12±3% for one and two stage operation respectively. In forced respiration in the early period, they were 31±12% (one stage) and 17±3% (two stage). However, in the late period, they were 12±4% (one stage) and 8±2% (two stage) for quiet respiration, 16±7% (one stage) and 12±5% (two stage) for forced respiration. All fluctuation rates were significantly higher than after operation for lung cancer. In forced respiration, the fluctuation rate was significantly higher in the early period after operation for esophageal cancer than in the late period. It was suggested that the marked fluctuation of the membranous part of the trachea in the early period after operation could be caused by removal of the esophagus which might have a role as a supporting tissue.