全腔镜Ivor-lewis术治疗早期食管下段癌  

Total esophagectomy Ivor-lewis for early lower esophageal carcinoma

作　　者：何弢[1] 马静[1] 李双龙 敖修儒 刘青[1] HE Tao;MA Jing;LI Shuanglong;AO Xiuru;LIU Qing(Chengdu Fifth People ＇s Hospital, Chengdu , Sichuan 610030, China)

机构地区：[1]成都市第五人民医院,四川610030

出　　处：《现代医药卫生》2018年第9期1330-1332,共3页Journal of Modern Medicine & Health

摘　　要：目的探索全腔镜经右胸上腹切口路径(Ivor Lewis)术治疗早期食管下段癌的可行性和近期疗效。方法选取2015年1月至2017年11月该院收治的早期食管下段癌患者20例,采用胸腔镜联合腹腔镜的全腔镜IvorLewis术行食管肿瘤切除后将管状胃和食管在胸腔内吻合,同时,清扫区域淋巴结,观察患者手术相关并发症发生情况、术中出血量、手术时间、平均住院时间、切口疼痛程度等。结果 20例患者均顺利完成手术,无围手术期死亡者,无输血者,未发生吻合口瘘、喉返神经损伤等;平均手术时间(449.40±52.94)min,平均术中出血量(308.00±81.24)m L,平均切口疼痛程度即疼痛视觉模拟评分(4.88±0.78)分,平均住院时间(18.28±6.05)d,平均淋巴结清扫数目(25.67±7.53)枚;肺部感染6例(30.0%),食管残端均为阴性。结论全腔镜Ivor Lewis术治疗早期食管下段癌是安全的,并没有明显增加围手术期相关并发症,同样能达到系统清扫淋巴结的目的,具有较好的可行性及安全性,近期疗效良好。Objective To explore the feasibility and the recent curative effect of totally thoracoscopic Ivor-lewis esophagectomy for the treatment of early lower esophageal carcinoma.Methods There were 20 cases data with early lower esopha-geal carcinoma who received totally thoracoscopic Ivor-lewis esophagectomy in Chengdu Fifth People＇s Hospital from January2015 to November 2017 and to observe the complications of surgery,the blood volume of the operation,the time of operation,the average hospital stay,and the degree of pain of the incision.Results All the 20 patients completed the operation success-fully.There was no peri operative death,no blood transfusion,no anastomotic fistula,recurrent laryngeal nerve injury,the aver-age operation time was（449.40±52.94）min,average intraoperative bleeding was（308.00±81.24）mL,and the average pain degree of the pain visual model score was（4.88±0.78）,and average hospitalization was（18.28±6.05）d,the average number oflymph node dissection was（25.67±7.53）,there were 6 cases of lung infection（30%）,and the esophageal stump were all nega-tive.Conclusion Totally thoracoscopic Ivor-lewis esophagectomy for the treatment of early lower esophageal carcinoma is safe.It does not significantly increase the perioperative complications,and can also achieve the purpose of cleaning lymph nodes.Ithas good feasibility and safety,and the short-term effect is good.

关 键 词：食管肿瘤/外科学 食管切除术 胸腔镜检查/方法 腹腔镜检查/方法 胸部 腹部 

分 类 号：R735.1[医药卫生—肿瘤]