改良Ivor-Lewis术治疗中下段食管癌42例经验体会

Clinical application of treatment of middle and lower esophageal cancer using reforming Ivor-Lewis operation: 42 cases report

目的探讨改良式上腹右胸两切口(改良Ivor-Lewis术)治疗中下段食管癌的临床应用价值。方法回顾分析该院2008年3月—2012年9月采用改良Ivor-Lewis术治疗42例中下段食管癌患者的临床资料。结果全组无死亡病例,吻合口瘘1例,急性呼吸功能不全2例,胃排空障碍2例,均经保守治愈,淋巴结清扫共357个,平均8.5个,淋巴结阳性率约25%。结论改良Ivor-Lewis术暴露良好,视野清晰,对胸腹腔纵隔淋巴结清扫彻底。是治疗中下段食管癌比较理想手术方式。

Objective To evaluate the efficacy of the reforming Ivor - Lewis esophagectomy for treatment of middle and lower esophageal cancer. Methods Retrospective analysis of 42 patients received reforming Ivor - Lewis esophagectomy from March 2008 to Sep 2012. Results There was no death, except for 1 anastomotic leakage,2 cases of ARI （acute respiratory insufficiency ） ,2cases of delayed gas tric emptying. All the patients recovered after non-surgical treatment. The total of lymph node dissection was 357, the average number was 8.5, the positive rate of lymph node was 25 %. Conclusion Reforming Ivor-Lewis esophagectomy is well exposing and having clear visu al. And it makes radial lymphadenectomy thoroughly in the splanchnocoel and mediastimun. Sepecially it＇ s easier and safety to anasto mose. So it proves to be an ideal operation procedure for middle and lower esophageal cancer.