Ivor Lewis与左胸后外侧手术径路治疗食管癌的效果分析

目的:淋巴结的清扫影响食管癌术后进一步治疗决策制定以及预后评估?本文前瞻性研究两种食管癌术式总的淋巴结以及各区域淋巴结的清扫情况?方法:随机选取2010年7月~2011年7月121例中下段食管癌的临床资料,分为Ivor Lewis术(41例)和左胸后外侧径路手术(80例)两组,比较总的淋巴结清扫数目?各区域淋巴结的清扫数目?淋巴结转移率与转移度?手术时间?出血量?术后胸腔引流量?术后住院天数?术后并发症发生率?结果: 两种术式在上纵隔淋巴结清扫数目及转移率?手术时间?术中出血量方面的差异具有统计学意义(P < 0.05);其余方面两组差异无统计学意义(P > 0.05)?结论: Ivor Lewis术在上纵隔清扫方面具有明显优势,更能准确表达术后的病理分期,指导下一步治疗?

Effectiveness analysis between Ivor Lewis approach and left posterolateral thoracic approach at esophagectomy

Objective:Lymph node involvement may impact postoperative therapeutic decision-making and prognosis in patients undergoing esophagectomy. This article is a prospective study of the total and the reginal lymph nodes dissection methods of the two surgical approachs (Ivor Lewis and left posterolateral thoracic approach). Methods:All 121 cases of middle and lower thoracic esophageal carcinoma from July 2010 to July 2011 were randomly divided into two groups,Ivor Lewis group with 41cases and left posterolateral thoracic approach group with 80 cases. Comparison was made on the number of lymph node resected,the number of each reginal lymph nodes resected,lymph node metastasis rate and degree,operation time,the volume of introperative blood loss,postoperative chest tube drainage,postoperative hospital stay,surgical complication rate. Results:There were significant differences in the resected number and metastasis rate of superiormediastinum lymph node,operation time,the volume of introperative blood loss between the two groups(P < 0.05). But there was no significant difference between two groups in the other factors(P > 0.05). Conclusion:Ivor Lewis approach has more advantages in the resection of superiormediastinum lymph node and is able to give a accurate evaluation on the postoperative pathological stage and guide the next treatment.