胸腹腔镜Ivor-Lewis食管癌切除术的应用可行性与安全性分析  

Feasibility and Safety of Laparoscopic Ivor-Lewis Resection for Esophageal Carcinoma

作　　者：苗国强 刘蒙 钮乐 MIAO Guoqiang;LIU Meng;NIU Le(The First Affiliated Hospital of He ＇nan University of Science and Technology,Luoyang,471000)

机构地区：[1]河南科技大学第一附属医院,471000 [2]河南省洛阳市第一人民医院,471000

出　　处：《实用癌症杂志》2018年第5期844-847,共4页The Practical Journal of Cancer

摘　　要：目的探讨胸腹腔镜Ivor-Lewis食管癌切除术的应用可行性与安全性。方法选择120例食管癌患者作为研究对象,根据入院顺序,按照随机数字表法分为观察组与对照组,各60例。观察组给予胸腹腔镜Ivor-Lewis切除术,对照组给予Sweet切除术。记录2组手术情况与安全性情况。结果所有患者都顺利完成手术,无中转开放手术。观察组的术后胸腔引流量、术中出血量、术后住院时间都明显少于对照组(P<0.05),但2组手术时间差异无统计学意义(P>0.05)。观察组术后1个月的胃瘘、肺部感染、胸胃综合征、吻合口狭窄等并发症发生情况明显少于对照组(P<0.05)。2组术后1个月的的血清IL-6与TNF-α都明显低于术前(P<0.05),且观察组术后1个月的血清IL-6与TNF-α明显低于对照组(P<0.05)。结论胸腹腔镜Ivor-Lewis食管癌切除术的应用具有很好的可行性,能减少手术创伤,减少术后并发症的发生,抑制炎症因子的表达,有利于患者康复。Objective To evaluate the feasibility and safety of laparoscopic Ivor-Lewis resection for esophageal carcinoma. Methods 120 patients with esophageal carcinom were selected as the research object,all the patients were randomly divided into the observation group and the control group,with 60 cases in each group,the observation group was given laparoscopic resection of Ivor-Lewis,the control group received Sweet resection,recorded surgery feasibility and safety of the 2 groups. Results All patients were operated successfully and were without conversions to open surgery,the postoperative chest drainage,intraoperative bleeding volume,postoperative hospitalization time in the observation group were significantly less than the control group（ P〈0. 05）,there was no significant difference between the 2 groups in operation time（ P〈0. 05）. The postoperative 1 month of incidence of complications such as gastric fistula,pulmonary infection,thoracic stomach syndrome and anastomotic stenosis in the observation group were significantly less than those of the control group（ P〉0. 05） The postoperative 1 month of serum levels of IL-6 and TNF-α in the observation group were significantly lower than those preoperative（ P〈0. 05）,while the postoperative 1 month of serum levels of IL-6 and TNF-α in the observation group were significantly lower than that of the control group（ P〈0. 05）. Conclusion Laparoscopic Ivor-Lewis resection for esophageal cancer has good feasibility,It can reduce surgical trauma,reduce postoperative complications and inhibit the expression of inflammatory factors,thereby promote the rehabilitation of patients.

关 键 词：胸腔镜 腹腔镜 IVOR-LEWIS手术 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]