改良Ivor-Lewis术式与左开胸术式在治疗中下段食管癌的疗效

The effect of improved Ivor-Lewis operation and left thoracotomy on lower esophageal carcinoma

目的:分析改良Ivor-Lewis术式与左开胸术式在治疗中下段食管癌的疗效,选择最佳手术治疗方案。方法:选择行手术治疗的160例中下段食管癌患者作为研究对象,随机分为观察组和对照组各80例。观察组患者行改良Ivor-Lewis术式,对照组患者行左开胸术式,对比两组中下段食管癌患者的临床治疗满意度、患者手术时间、术中出血量、带鼻胃管时间、淋巴结清扫数目、术后住院时间、并发症发生率等。结果:两组患者各项术后指标对比,观察组患者治疗满意度高于对照组(P<0.05),观察组患者淋巴结清扫数目多于对照组(P<0.05),术后住院时间短于对照组(P<0.05),组间患者术后并发症发生率、手术时间、术中出血量、带鼻胃管时间等指标差异无统计学意义(P>0.05)。结论:对比左开胸术,改良Ivor-Lewis术式在中下段食管癌手术治疗中的效果更优,且缩短了患者的住院时间,提高了患者治疗满意度,具有推广应用价值。

Objective： To analyze the effect of improved Ivor - Lewis operation and left thoracotomy on middle and lower esophageal carcinoma, and choose the best surgical treatment plan. Methods：t60 patients with middle and lower esophageal cancer who underwent surgical operation were randomly divided into two groups＇ the experimental group and the control group, 80 patients in each group. Improved Ivor- Lewis operation was undertaken in the experimental group, while left thoracotomy was undertaken in the control group. The two groups were compared in the clinical treatment satisfaction, the operation time, intraoperative blood loss, the time with nasogastric tube, the number of lymph node dissection, postoper- ative hospital stay, the incidence of complications and so on. Results：Compared postoperative indicators between the two groups, there was higher satisfaction in the experimental group than in the control group（ P 〈0.05 ） ; the number of lymph nodes dissection in the experimental group was more than that of the control group（ P 〈 0.05） ; the hospital stay was shorter than that of the control group （ P 〈 0.05 ） ; all the differences had statistical significance （ P 〈 0.05 ）. There were no significant differences in the postoperative complications, the operation time, intraoperative blood loss and the time with nasogastric tube between the two groups （ P 〉 0.05 ）. Conclusion ： Compared with left thoracotomy, improved Ivor - Lewis operation is more effective in treating lower esophageal cancer, which can shorten the hospital stay and improve the treatment satisfaction, thus worthy of popularizing and applying.