摘要
目的:探讨低位食管癌Ivor-Lewis与Sweet径路的治疗效果。方法:回顾性分析2005年1月至2012年1月106例胸下段食管癌患者的临床资料,按手术入路分为Ivor-Lewis组38例和Sweet组68例。结果:全组共清除淋巴结1120枚,平均10.57枚/人,Ivor-Lewis组平均(14.42±4.16)枚/人,显著高于Sweet组(8.41±5.49)枚/人(P=0.000<0.01);Sweet组手术时间(150.1±19.1)分钟,显著低于Ivor-Lewis组(189.9±9.5)分钟(P=0.000<0.01);两组转移性淋巴结19.8%(222/1120),Sweet组为17.5%(100/572),显著低于Ivor-Lewis组22.3%(122/548)(P=0.045);上纵隔淋巴结转移Ivor-Lewis组(19.5%,17/87)、腹腔淋巴结转移(17.1%,24/140)均显著高于Sweet组(7.5%,5/67;9.5%17/179)(P<0.05);而中、下纵隔淋巴结转移两组差异不显著;术后并发症总发生率为13.2%(14/106),两组无差异。结论:Ivor Lewis径路清除淋巴结的部位、数量较Sweet径路更多,特别是对于上纵隔及腹腔淋巴结的清除具有明显优势;而Sweet径路手术时间较短。
Objective：To study the clinical effects of Ivor-Lewis＇ and Sweet＇ surgical approaches for lower part of thoracic esophageal carcinoma.Methods：From January 2005 to January 2012,the clinical fingings of 106 cases with esophageal carcinoma in the lower thoracic sigment were retrospectively analyzed.The patients were divided into two groups as surgical aporoach：Ivor-Lewis group in 38 and Sweet group in 68.Results：Total 1,120 lymph nodes were removed during operation in the two groups with an average of 10.57 per person.The average of 14.42 ± 4.16 per person in Ivor-Lewis group was significantly higher than the average of 8.41 ± 5.49 per person in the Sweet group.On the contrary,the mean duration of operation in the Ivor-Lewis group with an average of 189.9 ± 9.5 minutes per person was significantly longer than 150.1 ± 19.1 minutes per person in the Sweet group.The overall lymph node metastasis in the two groups reached 19.8％ （222/1120）.However,Sweet group with an average of 17.5％ （100/572） was significantly lower than that in the Ivor-Lewis group of 22.3％ （122/548） （P =0.045）.Particularly,the metastatic lymph nodes of superior mediastinum and uper enterocoelia with average of 19.5％ （17/87） and 17.1％ （24/ 140） per person in the Ivor-Lewis group than that in Sweet group in 7.5％ （5/67） and 9.5％ （17/179） resprctively （P ＜0.05）.The total postoperative complication was 13.2％ （14/106） and there was no significant difference between the two groups.Conclusion：Ivor Lewis approach is superior to Sweet approach in the lymph nodes dissection of superior mediastinum and uper enterocoelia.But the operation taking time is longer in the former approach than that in the latter.
出处
《现代肿瘤医学》
CAS
2013年第11期2467-2469,共3页
Journal of Modern Oncology
