中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
12期
1180-1182
,共3页
食管肿瘤,中下段%经典Ivor-Lewis手术%改良Ivor-Lewis手术%治疗效果
食管腫瘤,中下段%經典Ivor-Lewis手術%改良Ivor-Lewis手術%治療效果
식관종류,중하단%경전Ivor-Lewis수술%개량Ivor-Lewis수술%치료효과
Esophageal neoplasms,middle and lower thoracic%Classic Ivor-Lewis procedure%Modified Ivor-Lewis procedure%Treatment outcomes
目的 通过对中下段食管癌经典Ivor-Lewis术式与改良Ivor-Lewis术式的治疗效果进行比较,重新评价经典Ivor-Lewis术式的临床应用价值.方法 收集在南京医科大学第一附属医院胸心外科2009年3月至2010年3月间接受改良Ivor-Lewis手术的140例(改良组)和2010年4月至2011年4月期间接受经典Ivor-Lewis手术的112例(经典组)食管中下段癌患者的临床资料.比较两组手术时间、术后并发症、淋巴结清扫数量、转移淋巴结数量及术后病理分期.结果 经典组平均手术时间为(212.0±39.5) min[含(22.0±3.4) min的重新消毒时间],稍长于改良组的(195.0±51.6) min,但差异并无统计学意义(P＞0.05).两组患者术中清扫淋巴结总数的差异无统计学意义[(21.2±3.2)枚/例比(18.6±5.5)枚/例,P＞0.05],但对于上纵隔淋巴结,经典组清扫数量明显多于改良组[(8.0±2.1)枚/例比(3.1±0.6)枚/例,P＜0.05].经典组术后检出有淋巴结转移者的比例明显高于改良组[41.1％(46/112)比27.9％(39/140),P＜0.05].结论 对于中下段食管癌,经典Ivor-Lewis术式在上纵隔淋巴结清扫效果及术后病理N分期的准确性方面较改良Ivor-Lewis术式更具优势,因而更符合肿瘤治疗原则.
目的 通過對中下段食管癌經典Ivor-Lewis術式與改良Ivor-Lewis術式的治療效果進行比較,重新評價經典Ivor-Lewis術式的臨床應用價值.方法 收集在南京醫科大學第一附屬醫院胸心外科2009年3月至2010年3月間接受改良Ivor-Lewis手術的140例(改良組)和2010年4月至2011年4月期間接受經典Ivor-Lewis手術的112例(經典組)食管中下段癌患者的臨床資料.比較兩組手術時間、術後併髮癥、淋巴結清掃數量、轉移淋巴結數量及術後病理分期.結果 經典組平均手術時間為(212.0±39.5) min[含(22.0±3.4) min的重新消毒時間],稍長于改良組的(195.0±51.6) min,但差異併無統計學意義(P＞0.05).兩組患者術中清掃淋巴結總數的差異無統計學意義[(21.2±3.2)枚/例比(18.6±5.5)枚/例,P＞0.05],但對于上縱隔淋巴結,經典組清掃數量明顯多于改良組[(8.0±2.1)枚/例比(3.1±0.6)枚/例,P＜0.05].經典組術後檢齣有淋巴結轉移者的比例明顯高于改良組[41.1％(46/112)比27.9％(39/140),P＜0.05].結論 對于中下段食管癌,經典Ivor-Lewis術式在上縱隔淋巴結清掃效果及術後病理N分期的準確性方麵較改良Ivor-Lewis術式更具優勢,因而更符閤腫瘤治療原則.
목적 통과대중하단식관암경전Ivor-Lewis술식여개량Ivor-Lewis술식적치료효과진행비교,중신평개경전Ivor-Lewis술식적림상응용개치.방법 수집재남경의과대학제일부속의원흉심외과2009년3월지2010년3월간접수개량Ivor-Lewis수술적140례(개량조)화2010년4월지2011년4월기간접수경전Ivor-Lewis수술적112례(경전조)식관중하단암환자적림상자료.비교량조수술시간、술후병발증、림파결청소수량、전이림파결수량급술후병리분기.결과 경전조평균수술시간위(212.0±39.5) min[함(22.0±3.4) min적중신소독시간],초장우개량조적(195.0±51.6) min,단차이병무통계학의의(P＞0.05).량조환자술중청소림파결총수적차이무통계학의의[(21.2±3.2)매/례비(18.6±5.5)매/례,P＞0.05],단대우상종격림파결,경전조청소수량명현다우개량조[(8.0±2.1)매/례비(3.1±0.6)매/례,P＜0.05].경전조술후검출유림파결전이자적비례명현고우개량조[41.1％(46/112)비27.9％(39/140),P＜0.05].결론 대우중하단식관암,경전Ivor-Lewis술식재상종격림파결청소효과급술후병리N분기적준학성방면교개량Ivor-Lewis술식경구우세,인이경부합종류치료원칙.
Objective To retrospectively evaluate the egicacy of classic and modified Ivor-Lewis surgical procedure in the treatment of mid-low thoracic esophageal cancer.Methods Clinical data of 140 patients with middle-lower thoracic esophageal cancer undergoing modified Ivor-Lewis esophagectomy from March 2009 to April 2010 (modified group) and 112 patients with same disease undergoing classic IvorLewis esophagectomy from April 2010 to April 2011 in our department were collected.Operative time,surgical complications,total number of harvested lymph node,distribution of lymph nodes,lymph node metastasis rate,as well as postoperative pathological stage were compared between two groups.Results There were no significant differences between two groups in general informations,operative time and surgical complications (P＞0.05).The number of harvested superior mediastinum lymph nodes in classic Ivor-Lewis group was significantly more than that in modified group (8.0±2.1 vs.3.1±0.6,P＜0.05).Ratio of postoperative positive lymph node metastasis was significantly higher in classic Ivor-Lewis group as compared to modified group [41.1％(46/112) vs.27.9％(39/140),P＜0.05].Conclusion As compared to modified Ivor-Lewis procedure,classic Ivor-Lewis procedure is better in the resection of superior mediastinum lymph node and the evaluation of postoperative pathological stage,therefore it conforms better to the principle of cancer treatment of esophageal carcinoma.
