全腔镜下Ivor-Lewis术与McKeown术治疗食管癌的临床疗效

目的探讨全腔镜下Ivor-Lewis术与McKeown术治疗食管癌的临床疗效。方法回顾性分析62例行食管癌根治术患者的临床资料,根据手术方式将其分为Ivor-Lewis组(33例)和McKeown组(29例)。比较2组患者围术期指标、术后并发症及肿瘤复发情况。结果2组患者围术期指标比较差异均无统计学意义(P>0.05)。与McKeown组相比,Ivor-Lewis组吻合口狭窄、吻合口瘘、喉返神经损伤发生率较低,差异有统计学意义(P<0.05);2组术后肺不张、肺部感染、胃排空延迟、乳糜胸等发生率比较差异无统计学意义(P>0.05)。术后6个月2组肿瘤复发率比较差异无统计学意义(P>0.05)。结论全腔镜下Ivor-Lewis术与McKeown术治疗食管癌均安全有效,但Ivor-Lewis术在吻合口狭窄、吻合口瘘及喉返神经损伤等并发症的控制上更有优势。

Clinical outcomes of full-endoscopic Ivor-Lewis operation and McKeown operation for esophageal cancer

Objective To investigate the clinical outcomes of full-endoscopic Ivor-Lewis operation and McKeown operation in the treatment of esophageal cancer.Methods The clinical data of 62 patients undergoing esophagectomy were retrospectively analyzed and patients were divided into Ivor-Lewis group(33 cases)and McKeown group(29 cases)according to the operation methods.Perioperative indexes,postoperative complications and tumor recurrence were compared between the two groups.Results There was no significant difference in perioperative indexes between the two groups(P>0.05).Compared with the McKeown group,the incidences of anastomotic stenosis,anastomotic fistula and recurrent laryngeal nerve injury in Ivor-Lewis group were lower,the differences were statistically significant(P<0.05).There was no significant difference in the incidences of postoperative atelectasis,pulmonary infection,delayed gastric emptying and chylothorax between the two groups(P>0.05).There was no significant difference in tumor recurrence rate between the two groups 6 months after operation(P>0.05).Conclusion Both full-endoscopic Ivor-Lewis operation and McKeown operation are safe and effective for esophageal cancer,but Ivor-Lewis operation has more advantages in the control of complications including anastomotic stenosis,anastomotic leakage and recurrent laryngeal nerve injury.