分析改良Ivor-Lewis手术治疗食管癌的适应证以及临床优势

Analysis of indications and clinical advantages of modified Ivor-Lewis operation for esophageal cancer

目的对比分析改良和传统Ivor-Lewis手术治疗食管癌的疗效.为临床治疗过程中术式的选择提供参考和借鉴。方法回顾150例食管癌患者的临床资料,对比分析传统Ivor-Lewis手术和改良Ivor-Lewis手术的淋巴结清扫数目、手术时间、术中出血量,肛门排气、首次下床和住院时间以及术后复发情况。结果观察组患者的住院时间、首次下床时间、肛门排气时间较对照组明显缩短(P<0.05),术后疼痛程度较对照组明显减轻(P<0.05),肺部感染发生率较对照组明显下降(P<0.05),随访期间复发率及术后1年生存率与对照组相比差异无统计学意义(P>0.05)<结论改良Ivor-Lewis手术辅以腹腔镜能够有效缓解患者术后疼痛,降低并发症的发生率,是治疗食管癌安全有效的微创手术治疗方式。

Objective To compare and analyze the curative effect of modified Ivor-Lewis operation and traditional Ivor-Lewis operation in the treatment of esophageal cancer,so as to provide reference for the selection of surgical methods in cliniccil treatment.Methods The clinical data of 150 patients with esophageal cancer were retrospectively analyzed.The number of lymph node dissection,operation time,intraoperative bleeding volume,anal exhaust,first time out of bed and hospital stay and recurrence alter Ivor-Lewis operation and modified Ivor-Lewis operation were compared and analyzed.Results The time of hospitalization,first time for being able to get out of bed and postoperative anal exhaust time in the observation group was significantly shorter than that in the control group(P<0.05),the degree of pain after operation was significantly less than that in the control group(P<0.05),the incidence of pulmonary infection and anastomotic leakage was significantly lower than that in the control group(P<0.05).There was no significant difference in recurrence rate and 1-year sun ival rate between the follow-up group and the control group(P>0.05).Conclusions Modified Ivor-Lewis operation combined with laparoscopy can effectively relieve postoperative pain and reduce the inc idence of complications.It is a safe and effective minimally invasive surgical treatment for esophageal cancer.