中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2015年
8期
1149-1151
,共3页
Ivor-Lewis术%胸腹腔镜%食管癌%下段癌
Ivor-Lewis術%胸腹腔鏡%食管癌%下段癌
Ivor-Lewis술%흉복강경%식관암%하단암
Lvor-Lewis%Thoracic-laparoscopy%Esophageal carcinoma%Lowest cancer
目的：对比观察Ivor-Lewis术联合胸腹腔镜食管癌切除术治疗食管下段癌的临床效果和预期预后。方法连续选取68例食管下段癌患者，根据简单数字表法将患者随机分为观察组和对照组，每组34例。观察组采用Ivor-Lewis术联合胸腹腔镜术，对照组采用左胸后外侧切口，并行胸内胃食管吻合术，对比分析两组患者的临床效果、不良反应及复发率的差异。结果两组患者均完成手术，无中转开腹病例。观察组手术时间、术中出血量、住院时间和术后胸腔引流量均显著优于对照组，差异均有统计学意义[手术时间：（165.3±53．7）比（214．3±71．5）min，t ＝3．814，P＝0．037；术中出血量：（153．6±23．1）mL 比（312．3±48．6）mL，t＝3．413，P＝0．042；住院时间：（7．4±1．2）比（10．5±2．3）d，t＝3．256，P＝0．043；术后胸腔引流量：（635.6±34．2）比（831．3±45．6）mL，t＝2．594，P＝0．039]。观察组术后的并发症发生率（主要包括肺部感染、胃排空障碍、吻合口瘘和膈疝）和随访6个月的复发率（包括原位复发、淋巴转移和血液转移）均显著低于对照组，差异均有统计学意义（并发症发生率：17．65％比38．24％，χ2＝4．012，P＜0．01；复发率：20．59％比47.06％，χ2＝4．825，P＜0．01）。结论 Ivor-Lewis术联合胸腹腔镜食管癌切除术治疗食管下段癌效果显著，安全性及患者耐受度较高，值得临床推广。
目的：對比觀察Ivor-Lewis術聯閤胸腹腔鏡食管癌切除術治療食管下段癌的臨床效果和預期預後。方法連續選取68例食管下段癌患者，根據簡單數字錶法將患者隨機分為觀察組和對照組，每組34例。觀察組採用Ivor-Lewis術聯閤胸腹腔鏡術，對照組採用左胸後外側切口，併行胸內胃食管吻閤術，對比分析兩組患者的臨床效果、不良反應及複髮率的差異。結果兩組患者均完成手術，無中轉開腹病例。觀察組手術時間、術中齣血量、住院時間和術後胸腔引流量均顯著優于對照組，差異均有統計學意義[手術時間：（165.3±53．7）比（214．3±71．5）min，t ＝3．814，P＝0．037；術中齣血量：（153．6±23．1）mL 比（312．3±48．6）mL，t＝3．413，P＝0．042；住院時間：（7．4±1．2）比（10．5±2．3）d，t＝3．256，P＝0．043；術後胸腔引流量：（635.6±34．2）比（831．3±45．6）mL，t＝2．594，P＝0．039]。觀察組術後的併髮癥髮生率（主要包括肺部感染、胃排空障礙、吻閤口瘺和膈疝）和隨訪6箇月的複髮率（包括原位複髮、淋巴轉移和血液轉移）均顯著低于對照組，差異均有統計學意義（併髮癥髮生率：17．65％比38．24％，χ2＝4．012，P＜0．01；複髮率：20．59％比47.06％，χ2＝4．825，P＜0．01）。結論 Ivor-Lewis術聯閤胸腹腔鏡食管癌切除術治療食管下段癌效果顯著，安全性及患者耐受度較高，值得臨床推廣。
목적：대비관찰Ivor-Lewis술연합흉복강경식관암절제술치료식관하단암적림상효과화예기예후。방법련속선취68례식관하단암환자，근거간단수자표법장환자수궤분위관찰조화대조조，매조34례。관찰조채용Ivor-Lewis술연합흉복강경술，대조조채용좌흉후외측절구，병행흉내위식관문합술，대비분석량조환자적림상효과、불량반응급복발솔적차이。결과량조환자균완성수술，무중전개복병례。관찰조수술시간、술중출혈량、주원시간화술후흉강인류량균현저우우대조조，차이균유통계학의의[수술시간：（165.3±53．7）비（214．3±71．5）min，t ＝3．814，P＝0．037；술중출혈량：（153．6±23．1）mL 비（312．3±48．6）mL，t＝3．413，P＝0．042；주원시간：（7．4±1．2）비（10．5±2．3）d，t＝3．256，P＝0．043；술후흉강인류량：（635.6±34．2）비（831．3±45．6）mL，t＝2．594，P＝0．039]。관찰조술후적병발증발생솔（주요포괄폐부감염、위배공장애、문합구루화격산）화수방6개월적복발솔（포괄원위복발、림파전이화혈액전이）균현저저우대조조，차이균유통계학의의（병발증발생솔：17．65％비38．24％，χ2＝4．012，P＜0．01；복발솔：20．59％비47.06％，χ2＝4．825，P＜0．01）。결론 Ivor-Lewis술연합흉복강경식관암절제술치료식관하단암효과현저，안전성급환자내수도교고，치득림상추엄。
Objective To study the clinical application effect of Ivor-Lewis combined with thoracic-lapa-roscopy for esophageal carcinoma resection in patients with esophageal lowest cancer.Methods A total of 68 patients with esophageal lowest cancer were individed into the observation group and control group by the random number method,each of 34 cases.The patients in the observation group received Ivor-Lewis combined with thoracic-lapa-roscopy,and the patients in the control group received intrathoracic esophagogastrostomy by left chest posterolateral incision,then to compare the differences of clinical effect and complications.Results The operation time,blood loss in-operation,in-hospital time,thoracic drainage after operation in the observation group were all significantly less than those of the control group[operation time:(165.3 ±53.7)vs (214.3 ±71.5)min,t=3.814,P=0.037;blood loss in-operation:(153.6 ±23.1)vs (312.3 ±48.6)min,t=3.413,P=0.042;in-hospital time:(7.4 ±1.2)vs (10.5 ±2.3)d,t=3.256,P=0.043;thoracic drainage after operation:(635.6 ±34.2)vs (831.3 ±45.6)mL,t=2.594,P=0.039].The total rate of complications including pulmonary infection,gastric emptying,anastomotic fistula and diaphragmatic hernia and the recurrence rate after 6 months including recurrence in situ,lymph node and hema-togenous metastasis were all significantly lower in the observation group(complication:17.65%vs 38.24%,χ2 =4.012, P<0.001;recurrence:20.59% vs 47.06%,χ2 =4.825,P<0.001).Conclusion Ivor-Lewis combined with tho-racic-laparoscopy for esophageal carcinoma resection in patients with esophageal lowest cancer is safe and effective.
