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回顾性分析28例食管癌患者行改良Ivor-Lewis术临床资料。手术先用腹腔镜游离胃并清扫腹腔淋巴结,部分患者腹腔镜下制作管状胃;再经胸腔镜辅助右胸8～12 cm小切口游离食管并清扫纵隔淋巴结,行食管胃右胸内吻合。结果显示所有患者均顺利完成手术,无中转手术及术中大出血。手术总时间为195～474 min,平均时间284 min;腹腔镜时间为30～210 min,平均时间76 min。术中总出血量50～1 800 ml,平均198 ml;平均清扫淋巴结15枚,转移率为60.7%(17/28)。术后病理分期:Ⅰ期2例、Ⅱ期13例、Ⅲ期12例、Ⅳ期1例。无吻合口瘘及死亡病例,3例肺部感染,1例乳糜胸;所有患者均治愈出院。
A retrospective analysis of 28 cases of esophageal cancer patients underwent modified Ivor-Lewis clinical data. Laparoscopic surgery first free gastric and abdominal lymph node dissection, some patients laparoscopic tube-shaped stomach; and assisted thoracoscopic right chest 8 ~ 12 cm small incision esophageal lymph nodes and clean, line esophageal right thoracic anastomosis. The results showed that all patients were successfully completed surgery, no transit surgery and intraoperative bleeding. The total operation time was 195 ~ 474 min, the average time was 284 min; the laparoscopic time was 30 ~ 210 min, the average time was 76 min. The total amount of blood loss during operation was 50 ~ 1 800 ml, with an average of 198 ml. There were 15 cases of lymph node dissection and the rate of metastasis was 60.7% (17/28). Postoperative pathological staging: Ⅰ in 2 cases, Ⅱ in 13 cases, Ⅲ in 12 cases, Ⅳ in 1 case. No anastomotic fistula and death cases, 3 cases of lung infection, 1 case of chylothorax; All patients were cured and discharged.