3D胸腹腔镜联合Ivor-Lewis食管切除术治疗中下段食管鳞状细胞癌的临床疗效  

Clinical efficacy of 3D thoracoscopic and laparoscopic Ivor-Lewis esophagectomy in the treatment of early-stage squamous cell carcinoma in the middle or lower esophagus

作　　者：郭建峰[1] 王凯 许瑞彬[1] 杨扬[1] GUO Jianfeng;WANG Kai;XU Ruibin;YANG Yang(Department of Thoracic Surgery,Affiliated Hospital of Yan’an University,Yan’an 716000,Shaanxi,China)

机构地区：[1]延安大学附属医院胸外科,陕西延安7160000

出　　处：《癌症进展》2020年第10期1061-1064,共4页Oncology Progress

摘　　要：目的探讨3D胸腹腔镜联合Ivor-Lewis食管切除术治疗中下段食管鳞状细胞癌的临床疗效。方法依据手术方式的不同将256例中下段食管鳞状细胞癌患者分为观察组和对照组,每组128例,对照组患者接受开放Ivor-Lewis食管切除术,观察组患者接受3D胸腹腔镜联合Ivor-Lewis食管切除术。比较两组患者手术前后的肺功能指标[肺活量(VC)、用力呼气量(FEV)、第一秒用力呼气量(FEV1)、用力肺活量(FVC)和最大通气量(MVV)]、血清免疫因子[转化生长因子-β(TGF-β)、白细胞介素(IL)-4、IL-6、肿瘤坏死因子-α(TNF-α)、IL-2]水平及术后生存情况。结果手术后,观察组患者的VC、FEV、FEV1、FVC和MVV均高于对照组,差异均有统计学意义(P﹤0.05)。手术后,观察组患者的血清TGF-β、IL-4水平均高于对照组,血清IL-6、TNF-α、IL-2水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的1、3、5年生存情况均明显优于对照组,差异均有统计学意义(P﹤0.01)。结论 3D胸腹腔镜联合Ivor-Lewis食管切除术能够明显减少手术对食管鳞状细胞癌患者肺功能的损伤,改善手术造成的炎症反应,同时能够提高患者的远期生存率。Objective To explore the clinical efficacy of three-dimensional(3D)thoracoscopic and laparoscopic Ivor-Lewis esophagectomy in the treatment of squamous cell carcinoma(SCC)in the middle and lower esophagus.Method According to the different surgical procedures,256 cases with SCC in the middle and lower esophagus were divided into study group and control group,with 128 cases in each.Patients in control group were treated with open Ivor-Lewis esophagectomy,while the patients in study group were administered with 3D thoracoscopic and laparoscopic Ivor-Lewis esophagectomy.The pulmonary function indicators[vital capacity(VC),forced expiratory volume(FEV),forced expiratory volume in first second(FEV1),forced vital capacity(FVC)and maximal voluntary ventilation(MVV)],serum immune factor[transforming growth factor-β(TGF-β),interleukin(IL)-4,IL-6,tumor necrosis factor-α(TNF-α),IL-2]levels and postoperative survival in the two groups were compared.Result After surgery,VC,FEV,FEV1,FVC and MVV in the study group were significantly higher than those in the control group(P<0.05).After surgery,the levels of TGF-βand IL-4 were significantly higher,while the levels of IL-6,TNF-αand IL-2 were significantly lower in study group versus control group(P<0.05).The 1-,3-,5-year survival of the study group were significantly better compared to control group(P<0.01).Conclusion The damage to lung function is significantly reduced in patients of SCC treated by 3D thoracoscopic and laparoscopic Ivor-Lewis esophagectomy,which improves the inflammatory reaction induced by surgery and confers higher long-term survival rate for patients.

关 键 词：3D胸腹腔镜 Ivor-Lewis食管切除术 食管鳞状细胞癌 

分 类 号：R735.1[医药卫生—肿瘤]