| 戎保林,郭明发,吴显宁,等.微创Ivor-Lewis术与微创Mckeown术治疗中段食管癌的效果比较[J].中国临床保健杂志,2018,21(4):497-500. |
| 微创Ivor-Lewis术与微创Mckeown术治疗中段食管癌的效果比较 |
| Comparison of Ivor-Lewis approach and Mckeown approach in treating mid-thoracic esophageal cancer |
| 投稿时间：2018-02-20 |
| DOI：10.3969/J.issn.1672-6790.2018.04.016 |
| 中文关键词: 食管肿瘤 食管切除术 内窥镜检查 治疗结果 |
| 英文关键词: Esophageal neoplasms Esophagectomy Endoscopy Treatment outcome 〖FL |
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| 中文摘要: |
| 目的 探讨微创Ivor-Lewis术及微创Mckeown术在中段食管癌根治手术中,两种微创术式的优越性及局限性。方法 回顾性分析距门齿25~30 cm范围内的中段食管癌患者,根据微创手术方式,分为微创Ivor-Lewis术组及微创Mckeown术组。两组分别随机抽取65例患者的病历资料,从食管残端癌残留、纵隔区域淋巴结清扫等手术相关技术指标和术后手术并发症方面分析比较。结果 术后病理显示,两组食管残端阳性率均为0。微创Mckeown术组与微创Ivor-Lewis术组比较:手术时间分别为(290.12±43.56)min、(270.50±40.26)min,P<0.05；术后吻合口瘘发生率分别为15.38% (10/65)和3.07% (2/65),P<0.05；左喉返神经链淋巴结分别为(4.64±3.56)枚、(3.38±2.21)枚,P<0.05,术后住院时间分别为(17.4±4.3)d和(15.5±4.8)d,P<0.05；术后住院费用分别为(5.9±0.8)万元比(5.5±0.9)万元,P<0.05。结论 微创Ivor-Lewis术及微创Mckeown术均是中段食管癌根治手术的可选术式,临床上可根据食管肿瘤的分期、术者的习惯、技术特点做不同选择。 |
| 英文摘要: |
| Objective To discuss the superiority and limitations of Ivor-Lewis approach and McKeown approach in treating mid-thoracic esophageal cancer.Methods Mid-thoracic esophageal cancer patients received minimally invasive esophagectomy surgeries were retrospectively analyzed.Tumor locations were within 25-30cm from the incisors and confirmed by endoscope.The clinical data of 65 patients for each group (Ivor-Lewis and Mckeown) were collected.The cancer residual of esophageal stump,mediastinal regional lymph node dissection and other operation related indexes,as well as postoperative complications were compared.Results According to pathological results,rates of cancer residual of esophageal stump were 0 for Both groups.There were differences between Mckeown group and Ivor-Lewis group,such as operation time:(290.12±43.56)min versus (270.50±40.26)min,P<0.05,anastomotic leakage:15.38%(10/65) versus 3.07% (2/65),P<0.05),lymph node counts of left recurrent laryngeal nerve:(4.64±3.56) versus (3.38±2.21),P<0.05,postoperative hospital stay:(17.4±4.3)d versus (15.5±4.8)d,P<0.05 and hospitalization expense(5.9±0.8) ten thousands yuan versus (5.5±0.9)ten thousands yuan,P<0.05.Conclusion Minimally invasive Ivor-Lewis and Mckeown approaches are both available for mid-thoracic esophageal cancer.Each of them has advantages and disadvantages and can be selected according to the stages of tumor,the habits of the operator and the technical features. |
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