摘要
目的探讨不同手术路径在胸中段食管癌患者中的应用效果。方法选取2013年3月至2015年3月间收治的胸中段食管癌患者100例,根据手术路径的不同分为左胸入路组和Ivor-lewis组,每组各50例,比较两组患者短期疗效指标、术后并发症发生情况等。结果 Ivor-lewis组患者的手术时间较短,手术出血量较少,与左胸入路组比较,差异均有统计学意义(均P<0.05)。两组患者首次下床活动时间、肛门排气时间、术后住院时间差异均无统计学意义(均P>0.05)。术后并发症方面,两组患者间呼吸衰竭和心房颤动发生率差异均无统计学意义(均P>0.05),而肺部感染率、切口感染率差异均有统计学意义(均P<0.05)。Ivor-lewis组患者生存率和无瘤生存率高于左胸入路组,但差异均无统计学意义(均P>0.05)。结论左胸入路和Ivor-lewis均为可行的手术路径。Ivor-lewis手术操作较为复杂,术后并发症和发病率较高,但患者术后无瘤生存率高。
Objective To explore the application efficacy of different surgical path in patients with esophageal carcinoma chest segment. Methods From March 2013 to March 2015,100 cases of esophageal cancer patients were enrolled in the study. According to different surgery path,they were divided into left breast approach and Ivor-lewis group,50 cases in each group. The short-term curative effect,the occurrence of postoperative complications such as analysis comparison betweent the two group were observed and compared. Results About short-term curative effect,compared with left breast approach,the operation time of the Ivor-lewis group was shorter and surgical blood loss was less,with significant difference（ P 〈 0. 05）; but the first time off the bed activity time,anal exhaust time,postoperative hospital stay between the two groups showed no significant differences（ P 〉 0. 05）. About postoperative complications,respiratory failure patients Ivor-lewis groups in 1 case（ 2. 0 %）,1 case of left breast approach group（ 2. 0 %）; About atrial fibrillation Ivor-lewis group 1 case（ 2. 0 %）,the left breast approach group 0 cese（ 0. 0 %）; There was no statistically significant difference（ P 〉 0. 05）;About lung infection,Ivor-lewis group of 14 cases（ 28. 0 %）,the left breast approach group 5 cases（ 10. 0%）; about infection of incision,increase of Ivor-lewis group 4 cases（ 8. 0%）,1 case of left breast approach group（ 2. 0 %）,and the difference was statistically significant（ P 〈 0. 05）. Log-rank test results showed the survival rate of Ivor-lewis group was slightly higher than that of the left breast approach,disease-free survival rates were slightly higher than the left breast approach group,but without significant differences（ P 〉 0. 05）. Conclusions Left breast approach and Ivor-lewis are feasible operation paths. Ivor-lewis operation is relatively complex,and the incidence of postoperative complications is higher,but the postoperative disease-free survival rate is good.
出处
《中国肿瘤临床与康复》
2016年第4期427-429,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
食管肿瘤
不同手术路径
治疗结果
Esophageal neoplasms
Different operation path
Treatment outcome
