胸腹腔镜联合微创Ivor-Lewis与McKeown手术治疗中下段食管癌疗效比较分析  

Comparative Analysis of Curative Effect of Thoracic Laparoscopic Combined with Minimally Invasive Ivor-Lewis and McKeown Operation in the Treatment of Middle and Lower Esophageal Carcinoma

作　　者：侯仕振 矫文捷[1] 

机构地区：[1]青岛大学

出　　处：《世界最新医学信息文摘》2017年第12期3-5,共3页World Latest Medicine Information Electronic Version

摘　　要：目的比较胸腹腔镜联合微创Ivor-Lewis与McKeown手术治疗胸中下段食管癌的临床疗效,为胸中下段食管癌患者选择合适的手术方式提供临床依据。方法回顾性分析本院胸外科50例胸腹腔镜联合胸中下段食管癌根治术的临床资料。根据手术方法不同将50例患者分为微创Ivor-Lewis组(24例)及微创McKeown组(26例)。比较两种手术方式患者的围手术期资料及术后并发症情况。结果微创Ivor-Lewis组手术时间、术后住院时间与微创McKeown组比较差异无统计学意义(P>0.05)。微创Ivor-Lewis组术后放管时间、术后进食时间长于微创McKeown手术组(P<0.05);而两组间术中出血量、清扫淋巴结数目、手术费用差异无统计学意义(P>0.05)。微创Ivor-Lewis组吻合口瘘、喉返神经损伤发生率均低于左颈部吻合组(P<0.05);两组之间术后切口感染、肺部感染、吻合口狭窄、乳糜胸发生、淋巴结转移率比较差异无统计学意义(P>0.05)。结论微创Ivor-Lewis与微创McKeown手术均可作为治疗中下段食管癌的术式,能够达到完全切除肿瘤、彻底清扫淋巴结及准确分期的目的,但微创Ivor-Lewis具有术后更低的吻合口瘘、喉返神经损伤和肺部感染等主要并发症发生率,具有可行性、安全性和良好的近期临床疗效。Objective To compare the clinical efficacy of thoracic and laparoscopic combined with minimally invasive Ivor- Lewis and McKcown in the treatment of thoracic and lower esophageal carcinoma, and to provide the clinical basis for the choice of appropriate surgical methods for patients with lower thoracic esophageal cancer. Methods Retrospective analysis of thoracic surgery in our hospital 50 cases of thoracic and laparoscopic thoracic and lower esophageal cancer radical surgery clinical data. Forty patients were divided into minimally invasive Ivor-Lewis group （n = 24） and minimally invasive McKeown group （n = 26） according to different surgical methods. To compare the perioperative information and postoperative complications of the two surgical methods. Results There was no significant difference in the operation time and postoperative hospitalization time between the minimally invasive lvor-Lewis group and the minimally invasive McKeown group （P〉0.05）.In the minimally invasive Ivor-Lewis group, the time of catheter drainage and postoperative feeding time was longer than that of the minimally invasive McKeown group （P〈0.05）; There was no significant diffcrence between the two groups in the amount of bleeding, number of lymph nodes dissection and the cost of operation （P〉0.05）. The incidence of anastomotic leakage and recurrent laryngeal nerve injury in the minimally invasive Ivor-Lewis group was lower than that in the left cervical anastomosis group （P〈0.05）; Between the two groups of postoperative incision infection, pulmonary infection, anastomotic stenosis, chylothorax, lymph node metastasis rate had no significant difference （P〉0.05）.Conclusions Minimally invasive Ivor-Lewis and minimally invasive McKeown surgery can be used as a surgical procedure for the treatment of lower esophageal cancer, which can achieve complete removal of the tumor, complete cleaning of lymph nodes and accurate staging, but minimally invasive Ivor- Lewis has lower postoperative of the anastomotic

关 键 词：食管癌 胸腔镜 微创McKeown术 微创Ivor-Lewis术 

分 类 号：R735.1[医药卫生—肿瘤]