局部晚期食管鳞癌患者经左颈-右胸-腹三切口食管癌根治术(胸腹腔镜)与Ivor-Lewis(胸腹腔镜)术治疗的效果对比分析  

Comparative analysis of the efficacy of radical esophagectomy(thoracoscopy)and Ivor-Lewis(thoracoscopy)for patients with locally advanced esophageal squamous cell carcinoma through left cervical-right thoracic-abdominal three incisions

作　　者：黄千长 安小康[2] 唐东方 Huang Qian-chang;An Xiao-kang;Tang Dong-fang(Department of Thoracic Surgery,Kaifeng Cancer Hospital,Kaifeng 475003,Henan,China;Department of Thoracic Surgery,TheFirst Affiliated Hospital of Henan University,Kaifeng 475001,Henan,China)

机构地区：[1]开封市肿瘤医院胸外科,河南开封475003 [2]河南大学第一附属医院胸外科,河南开封475001

出　　处：《四川生理科学杂志》2024年第10期2171-2174,共4页

摘　　要：目的:对比经左颈-右胸-腹三切口食管癌根治术(胸腹腔镜)、经腹胸二切口食管癌根治术(Ivor-Lewis esophagectomy,Ivor-Lewis)(胸腹腔镜)治疗局部完全食管鳞癌患者效果。方法:选取2018年5月至2023年5月期间在我院确诊的100例局部晚期食管鳞癌患者作为研究对象,依据治疗方案分为对照组和研究组,各50例。对照组接受胸腹腔镜联合Ivor-Lewis术,研究组接受胸腹腔镜联合左颈-右胸-腹三切口食管癌根治术。对比2组手术指标、并发症状况以及围术期免疫功能、应激反应[C反应蛋白(C reactive protein,CRP)、皮质醇(Cortisol,Cor)]、肠道功能(二胺氧化酶、D-乳酸)。结果:和对照组相比,研究组住院时间、术中失血量、首次进食时间、手术时间明显较少,淋巴结清扫数明显较多(P<0.05)。术后3 d,研究组血清二胺氧化酶、D-乳酸、CRP与Cor水平明显低于对照组(P<0.05);研究组CD4^(+)、CD4^(+)/CD8^(+)明显高于对照组(P<0.05)。研究组并发症发生率明显低于对照组(P<0.05)。结论:较胸腹腔镜联合Ivor-Lewis术,胸腹腔镜联合左颈-右胸-腹三切口食管癌根治术治疗局部晚期食管鳞癌患者效果显著,可改善手术效果,促进肠道功能恢复,减轻应激反应,对免疫功能影响较小,并能保障手术安全性。Objective:To compare the efficacy of radical resection for locally advanced esophageal squamous cell carcinoma through three incisions(left cervical,right thoracic,and abdominal)(thoracoscopic surgery)and two incisions(abdominal and thoracic)(Ivor-Lewis esophagectomy)(thoracoscopic surgery).Methods:A total of 100 patients with locally advanced esophageal squamous cell carcinoma diagnosed in our hospital from May 2018 to May 2023 were selected as the research subjects.They were divided into a control group and a research group according to the treatment plan,with 50 cases in each group.The control group received thoracoscopic-laparoscopic combined Ivor-Lewis surgery,while the research group received thoracoscopic-laparoscopic combined left cervical-right chest-abdominal three-incision radical esophagectomy.Surgical indexes and complication status,as well as perioperative immune function,stress response[C reactive protein(CRP),cortisol(Cor)],and intestinal function(diamine oxidase,D-lactate)were compared between the 2 groups.Results:Compared with the control group,the study group had significantly less hospitalization time,intraoperative blood loss,first meal time,and operation time,and significantly more lymph node dissection(P<0.05).Three days after surgery,the serum levels of diamine oxidase,D-lactate,CRP,and Cor in the study group were significantly lower than those in the control group(P<0.05);the CD4+,CD4+/CD8^(+)in the study group were significantly higher than those in the control group(P<0.05).The incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion:Compared with thoracoscopic and laparoscopic combined with Ivor-Lewis surgery,thoracoscopic and laparoscopic combined with left cervical-right chest-abdominal three-incision radical resection for the treatment of locally advanced esophageal squamous cell carcinoma patients has significant effects,which can improve surgical outcomes,promote intestinal function recovery,reduce stress response,have

关 键 词：食管癌 鳞癌 胸腹腔镜 食管癌根治术 切口 

分 类 号：R735.1[医药卫生—肿瘤]