食管胃结合部腺癌微创与开放两种不同术式的短期疗效对比

A comparative study of short-term efficacy of minimally invasive surgery and open esophagogastrectomy in treatment of adenocarcinoma of esophagogastric junction

[目的]探讨全腔镜微创改良Ivor-Lewis术与左开胸术两种术式对食管胃结合部腺癌的手术疗效比较。[方法]回顾性分析2016年6月至2018年7月于河南大学第一附属医院行此两种术式手术治疗并随访的56位食管胃结合部腺癌患者的临床病历资料。比较两组患者围手术期的相关指标(住院时间、手术时间、术中出血量、带胃管时间、淋巴结清除数量)和术后肺部感染、心律失常、乳糜胸、吻合口漏、吻合口狭窄、喉返神经损伤等并发症的发生率。[结果]两组患者各项术后指标对比,观察组术中出血量、总住院时间及淋巴结清扫数量等指标均优于对照组(P≤0.05),手术时间较对照组时间长。两组患者术后并发症发生率及带胃管时间等指标差异无统计学意义(P>0.05)。[结论]改良Ivor-Lewis术治疗食管胃结合部腺癌围手术期相关指标优于左开胸术,可缩短住院时间,且淋巴结清扫更加彻底,疗效理想,具有更高的临床应用价值。

[Objective]To compare the short-term effect of totally endoscopic modified Ivor-Lewis operation and left thoracotomy in the treatment of adenocarcinoma of esophagogastric junction(AEG).[Methods]Retrospective comparison was performed on the clinical data in 56 cases of AEG treated with two different esophagogastrectomy in our hospital from June 2016 to July 2018.Compared the relevant indicators of the two groups of patients during the peropevative period(include hospital stay,operation time,intraoperative bleeding volume,nasogastric tube time,lymph node dissection number)and the rate of postoperative complication(pneumonia,arrhythmia,chylothorax,anastomotic leakage and stricture,recurrent laryngeal nerve injury).[Results]Comparison of various postoperative indeves between the two groaps of patients.The observation group’s intraoperative blood loss,total hospital stay,and number of lymph node disseetion were superior to the control group(P>0.05).But the observation group had longer operation time than the control group,postoperative complication rate and nasogastric tube time between two group had no significant difference(P>0.05).[Conclusion]Modified Ivor-lewis operation is better than left open thoracformy in the treatment of AEG which can shorten the length of hospitol stay.