胸腹腔镜联合MIILE治疗对中下段食管癌疗效分析  

Efficacy of Thoracic Laparoscopy Combined with MIILE on Middle-lower Section Esophageal Cancer

作　　者：匡必婧 胡杨[1] 余娜[1] 马林[1] 宋尚岐 张小龙 牛玲莉 KUANG Bijing;HU Yang;YU Na;MA Lin;SONG Shangqi;ZHANG Xiaolong;NIU Lingli(West China Hospital of Sichuan University,Chengdu 610041,China;Chengdu Shangjin Nanfu Hospital,Chengdu 610117,China)

机构地区：[1]四川大学华西医院,四川成都610041 [2]成都上锦南府医院,四川成都610117

出　　处：《北华大学学报（自然科学版）》2020年第1期62-65,共4页Journal of Beihua University（Natural Science）

基　　金：四川省科技计划项目(2018JY0596)

摘　　要：目的探讨胸腹腔镜联合微创Ivor-Lewis手术(MIILE)治疗中下段食管癌患者的临床疗效.方法将95例中下段食管癌患者分为行胸腹腔镜+MIILE的MIILE组(43例)和行微创McKeown术(MIME)的MIME组(52例),对比两组围手术期指标、术后并发症、术后疼痛和术后生存率.结果 MIILE组手术时间、术中出血量、术后进食时间、术后住院时间均低于MIME组(P<0.05);两组清扫淋巴结数、淋巴结转移率、R0切除率、术后拔胸管时间比较差异无统计学意义(P>0.05);MIILE组术后并发症总发生率低于MIME组(P<0.05);MIILE组术后1,7d视觉模拟评分法(VAS)均低于MIME组(P<0.05);两组术后14 d VAS评分差异无统计学意义(P>0.05);MIILE组术后1个月生活质量核心量表(QLQ-30)评分高于MIME组(P<0.05),两组复发或转移率、生存率及术后6个月QLQ-30评分差异无统计学意义(P>0.05).结论胸腹腔镜联合MIILE是治疗中下段食管癌安全有效的微创手术,可减少术后并发症,提高患者早期的生活质量.Objective To explore the clinical efficacy of thoracic laparoscopy combined with minimally invasive Ivor-Lewis esophagectomy( MIILE) on patients with middle-lower section esophageal cancer. Method 95 patients with middle-lower section esophageal cancer were divided into MIILE group( n = 43,thoracic laparoscopy +MIILE) and MIME group( n = 52,minimally invasive Mc Keown esophagectomy). Perioperative indexes,postoperative complications,postoperative pain and postoperative survival rate were compared between the two groups. Results The operative time,intraoperative blood loss,postoperative feeding time and postoperative hospital stay in MIILE group were shorter than those in MIME group( P < 0. 05). There was no significant difference in the number of dissected lymph node,lymph node metastasis rate,R0 resection rate and postoperative chest tube removal time between two groups( P>0. 05). The total incidence rate of postoperative complications in MIILE group was lower than that in MIME group( P<0. 05). The visual analogue scale( VAS) in MIILE group at 1 d and 7 d after operation were lower than those in MIME group( P < 0. 05). There was no significant difference in VAS score between two groups at 14 d after operation( P >0. 05). The score of quality of life core scale( QLQ-30) at 1 month after operation in MIILE group was higher than that in MIME group( P<0. 05),and there was no significant difference in recurrence rate or metastasis rate,survival rate and QLQ-30 score at 6 months after operation between two groups( P>0. 05). Conclusion Thoracic laparoscopy combined with MIILE is a safe and effective minimally invasive surgery for middle-lower section esophageal cancer,and it can reduce postoperative complications and improve early quality of life.

关 键 词：胸腹腔镜 微创 Ivor-Lewis术 中下段 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]