胸腹腔镜联合Ivor Lewis术与McKeown术治疗胸中下段食管癌近期疗效的比较

Short-term Curative Effect of Thoraco-laparoscopic Combined with Ivor Lewis Operation and Mc Keown Operation on Lower Thoracic Esophageal Cancer

目的比较胸腹腔镜联合Ivor Lewis术与McKeown术治疗胸中下段食管癌的临床近期疗效。方法采用随机分组的方法,将120例胸中下段食管癌的患者均分为2组,分别行Ivor Lewis术与McKeown术,比较两组患者的手术指标、治疗后两组患者的淋巴结清扫及转移情况、两组患者的术后并发症和术后6个月复发情况、两组患者治疗前后的生活质量。结果两组患者接受不同的治疗后,其淋巴结清扫及转移情况的差异有统计学意义(χ~2=76. 13,P=0. 00)、术后并发症和术后6个月复发情况差异有统计学意义(χ~2=55. 24,P=0. 00)、生活质量差异显著(χ~2=79. 63,P=0. 00);造成两组患者间淋巴结清扫及转移情况差异、术后并发症和术后6个月复发情况差异和生活质量差异显著的主要原因在于:Ivor Lewis组和McKeown组的疗效差异。结论 Ivor Lewis术与McKeown术对于治疗胸中下段食管癌均有一定疗效,McKeown术的治疗效果相对更好,并发症发生率更低。

Objective To evaluate the short-term clinical efficacy of thoracic-laparoscopic combined with Ivor Lewis and McKeown in the treatment of lower thoracic esophageal cancer and to provide clinical data for the treatment of lower thoracic esophageal cancer.Methods A total of 120 patients with lower thoracic esophageal cancer were randomly divided into two groups.The patients were treated with Ivor Lewis and McKeown respectively.The operation indexes of the two groups were compared.The lymph node dissection and Metastasis,postoperative complications in both groups and relapse 6 months after operation,the quality of life of the two groups before and after treatment were statistically different.Results The difference of lymph node dissection and metastasis between the two groups was statistically significant(P<0.05),postoperative complications and recurrence after 6 months were statistically significant(P<0.05).There were significant differences in quality of life between the two groups(P<0.05);differences in lymph node dissection and metastasis between the two groups were observed,postoperative complications and recurrence after 6 months The main reason for the significant difference in quality is the difference in efficacy between the McKeown and Ivor Lewis groups.Conclusion Lvor Lewis surgery and McKeown surgery have certain curative effect on the treatment of middle and lower thoracic esophageal cancer.The treatment effect of McKeown surgery is relatively better and the incidence of complications is relatively lower.