Ivor-Lewis和Sweet术式在中下段食管鳞癌根治术的应用

Application of Ivor-Lewis and Sweet surgical methods in treating patients with carcinoma in middle and lower esophagus

目的比较Ivor-Lewis和Sweet术式在中下段食管鳞癌根治术的应用。方法胸中下段食管鳞癌患者254例分别采用Ivor-Lewis术式(Ivor-Lewis组,102例)和Sweet术式(Sweet组,152例)手术,比较两组淋巴结清扫数量和术后并发症发生情况。结果 Ivor-Lewis组淋巴结清扫总数、上纵隔淋巴结清扫数、腹腔淋巴结清扫数均多于Sweet组(P<0.05),而手术时间短于Sweet组(P<0.05)。Ivor-Lewis组肺部并发症和心律失常发生率均低于Sweet组(P<0.05);两组喉返神经损伤、吻合口瘘、心力衰竭、切口感染发生率差异无统计学意义(P>0.05)。结论 Ivor-Lewis术式对心肺系统干扰较小,对上纵隔及腹腔淋巴结的清扫具有明显优势。

Objective To compare the application of Ivor-Lewis and Sweet surgical methods in treating the patients with carcinoma in middle and lower esophagus.Methods A total of 254 patients with carcinoma in middle and lower esophagus was divided into groups of A（operated with Ivor-Lewis method,102cases）and B（operated with Sweet method,152cases）.The number of lymph nodes dissected and the incidence of postoperative complications were compared between two groups.Results Compared to group B,group A spent shorter time for surgery and had more lymph nodes in upper mediastinum and celiac lymph nodes dissected.The incidences of postoperative pulmonary complications and arrhythmia were significantly lower in group A than those in group B（P〈0.05）.There were no significant differences between two groups in the incidences of recurrent laryngeal nerve injury,anastomotic fistula,heart failure,incision infection（P〉0.05）.Conclusion Ivor-Lewis method used for treating the patients with carcinoma in middle and lower esophagus has the advantages of smaller influence on cardiopulmounry function and more lymph nodes in upper mediastinum and celiac lymph nodes dissected.