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目的:比较Ivor-Lewis手术与经左胸一切口手术治疗中下段食管癌的优缺点及术后并发症发生的差异.方法:回顾性分析2010-01/2012-12收治的269例中下段食管癌手术资料,Ivor-Lewis 114例,左胸一切口155例,比较两组患者手术相关参数以及围手术期并发症.结果:Ivor-Lewis手术组和经左胸组淋巴结清扫平均数分别是16.5枚±3.5枚和11.6枚±2.2枚(P<0.001);上纵隔淋巴结转移率分别是15.72%、8.14%(2=6.32,P<0.05);上切缘阳性率分别为0%、1.9%(P<0.05);术后两组并发症发生率分别是23.7%、27.7%(P>0.05),呼吸衰竭及心律失常发生率低于左胸组;术后住院日低于左胸组.结论:Ivor-Lewis手术治疗中下段食管癌,在淋巴结清扫及上切缘阳性率,术后患者恢复方面有一定优势,术后心肺并发症少.
OBJECTIVE: To compare the advantages and disadvantages of Ivor-Lewis surgery and the surgical treatment of middle and lower esophageal cancer by left thoracotomy and the difference of postoperative complications.Methods: A retrospective analysis of 269 cases of middle and lower esophagus treated from 2010-01 / 2012-12 The surgical data of 114 patients with Ivor-Lewis and 155 patients with left-thoracic incision were collected and the operative parameters and perioperative complications were compared between the two groups.Results The average number of lymph nodes dissection in the Ivor-Lewis group and the left thoracic group were 16.5 3.5 ± 11 and ± 2.2 (P <0.001). The rates of lymph node metastasis in the mediastinum were 15.72% and 8.14% (2 = 6.32, P <0.05) (P <0.05). The incidence of postoperative complications in both groups was 23.7% and 27.7% (P> 0.05) respectively. The incidence of respiratory failure and arrhythmia was lower in the two groups than in the left chest group. The postoperative hospital stay was lower than that in the left chest group. Conclusion: Ivor-Lewis surgical treatment of mid and lower esophageal cancer in the lymph node dissection and the margin of the positive rate, postoperative recovery of patients has some advantages, less postoperative complications of heart and lung.