全腔镜胸内吻合与Ivor-Lewis手术治疗食管癌的疗效比较

目的:探讨微创Ivor-Lewis手术和开放Ivor-Lewis手术的安全性及临床疗效。方法:回顾本院2016年1月至2018年4月收治的114例中下段食管癌患者,依据其手术方式分为微创Ivor-Lewis组(53例)、开放Ivor-Lewis组(61例),分析对比两组手术时间、淋巴结清扫数目、术中出血量、术后并发症、住院天数、生存质量的差异。结果:微创组总手术时间(190.6±42.4)min]与开放组(195.4±48.5)min]接近,术中出血量(110.2±43.9)ml]少于开放组(185.4±76.3)ml],术后肺部感染发生率(7.5%vs 21.3%)明显减低,差异有统计学意义(P<0.05);两组患者在淋巴结清扫数目(23.8±6.3)枚vs(22.1±6.8)枚]、住院天数及生存率等方面比较差异无统计学意义(P>0.05)。结论:在掌握适应证的情况下,微创Ivor-Lewis安全可行,其术后并发症低于开放手术。

A comparative study on total endoscopic thoracic anastomosis and Ivor-Lewis surgery in the treatment of esophageal cancer

Objective:To investigate the safety and clinical efficacy of minimally invasive Ivor-Lewis esophagectomy(MIIE)and open Ivor-Lewis surgery.Methods:From January 2016 to April 2018，114 patients with esophageal cancer were divided into MIIE group(n=53)and OPEN group(n=61).The differences of operation time，number of lymph node dissection，intraoperative blood loss，postoperative complications，length of hospitalization and quality of life between the two groups were analyzed statistically.Results:There were no perioperative deaths in all cases.There was no statistical difference in the total operation time［(190.6±42.4)min vs (195.4±48.5)min］，total resected lymph nodes(23.8±6.3 vs 22.1±6.8)，time of hospital stay and survival time(P>0.05).However，There was a statistical difference in intraoperative blood loss［(110.2±43.9)ml vs (185.4±76.3)ml］，incidence of pulmonary infection(7.5% vs 21.3%)(P<0.05).Conclusion:Minimally invasive Ivor-Lewis is safe and feasible when indications are mastered，and its postoperative complications are lower than those of open surgery.