Ivor—Lewis手术治疗食管癌的近期临床疗效分析  

Short-term clinical efficacies of esophageal carcinoma treated surgically by Ivor-Lewis approach

作　　者：马龙飞[1] 相加庆[1] 李鹤成[1] 李斌[1] 胡鸿[1] 

机构地区：[1]复旦大学附属肿瘤医院胸外科,上海200032

出　　处：《中华医学杂志》2012年第23期1618-1620,共3页National Medical Journal of China

摘　　要：目的通过Ivor-Lewis手术治疗食管癌的近期临床疗效分析，探讨食管癌的淋巴结转移特点，并评价该术式治疗中下段食管癌的安全性及有效性。方法上海复旦大学附属肿瘤医院胸外科从2005年开始开展食管癌Ivor-Lewis手术，收集2007至2010年间404例食管癌患者Ivor—Lewis手术的情况，使用AJCC软件进行概率统计分析。结果404例患者未出现术后院内死亡病例，共有89例患者（22．0％）出现了101例次的术后并发症。且当肿瘤原发灶尚处于T1时，就有可能出现转移。结论食管癌很易且较早发生淋巴结转移，其特点即是当肿瘤原发灶尚处于T1时，就有可能出现转移。研究结果倾向于根据患者转移淋巴结的解剖部位数能更好的预测患者的预后。总之Ivor—Lewis手术＋两野淋巴结清扫对于中下段食管癌来说是安全而有效的。Objective To explore the short-term clinical efficacies of treating esophageal carcinoma surgically by Ivor-Lewis approach so as to summarize the characteristics of lymph node metastasis of esophageal cancer and evaluate the safety and effectiveness of surgical treatment of middle and lower esophagus. Methods Our hospital started the Ivor-Lewis approach of esophageal cancer from 2005. During the period of 2007-2010, a total of 404 patients underwent the Ivor-Lewis approach for esophageal cancer. And the AJCC software was used for the probability statistical analysis. Results None of them died. But 89/101 patients （22. 0% ） had the occurrences of postoperative complications. And while still within the original stage of T1, tumor probably metastasized. Conclusion Esophageal cancer has an early tendency of metastasis. Based upon the anatomic locations of metastatic lymph nodes, it is better to predict the prognosis of patients. Thus the combined regimen of Ivor-Lewis surgery plus two-field lymphadenectomy is both safe and efficacious for esophageal carcinoma in the middle and lower segments.

关 键 词：食管肿瘤 淋巴转移 IVOR-LEWIS手术 

分 类 号：R735.1[医药卫生—肿瘤]