摘要
目的:探讨胸和腹腔镜联合Ivor-Lewis食管癌根治术的可行性及近期疗效。方法:选取2011-10-2012-10安徽省立医院胸外科82例施行微创Ivor-Lewis食管癌根治术患者。回顾性分析患者临床病理资料,分析术中情况、术后死亡率和并发症。结果:共79例患者完成微创Ivor-Lewis食管癌根治术,3例患者中转为小切口开胸手术。所有患者病理类型为鳞癌。平均手术时间(255.2±39.5)min,术中平均出血量(185.0±34.8)mL,平均清除淋巴结(31.4±5.6)枚,术后平均住院日(11.2±6.5)d。所有患者未出现术中死亡。2例患者出现术后住院期间死亡,其中1例死于多器官功能衰竭,另1例死于呼吸衰竭。术后出现吻合口瘘3例,乳糜胸4例,吻合口出血1例,声音嘶哑2例,肺部感染2例。心律失常2例。总并发症发生率为18.3%(15/82)。结论:微创Ivor-Lewis食管癌根治术技术上可行,手术安全性及近期疗效满意,值得在临床推广。
OBJECTIVE： To evaluate the efficacy and safety of minimally invasive Ivor-Lewis esophagectomy. METHODS： Between October 2011 and October 2012,Eighty-two patitents with thoracic esophageal carcinoma from De- partment of Thoracic Surgery Anbui Provincial Hospital were performed with minimally invasive Ivo-Lewis esophagecto- my. The clinical records of these patients were retrospectively reviewed, and intraoperative, postoperative mortality and complications were analyzed. RESULTS： Total of 79 patients completed minimally invasive lvor-Lewis esophageal cancer radical, 3 patients were turned to small incision thoracotomy in surgery. The pathologic diagnosisi of all patients were squamous cell carcinoma. The average operation time was （255.2 ±39. 5） min. The average blood loss was （185. 0 ± 34.8） mL,and the average number of harvested lymph nodes was 31.4±5.6. The mean postoperative hospital stay was （11.2±6.5） days. There was no in-operation death in the group. Two postoperative hospital stay patients dead,including 1 case died of multiple organ failure and anather 1 case died of respiratory failure. Other complications respectively were anastomotic fistula in 3 cases, postoperative chylothorax in 4 cases,anastomotic bleeding in 1 case, hoarse in 2 cases, pul- monary infection in 2 cases,arrhythmia in 2 cases. Total complication rate was 18. 3% （15/82）. CONCLUSIONS： Mini- mally invasive Ivor-Lewis esophagectomy is surgically safe and oncologically adequate. It is worth of advocating clinically.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2014年第6期454-457,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
食管肿瘤
胸腔镜
腹腔镜
外科手术
微创性
esophageal neoplasms
thoracoscopy
laparoscopy
surgical procedures, minimally invasive
