全腔镜Ivor-Lewis术式治疗胸中下段食管癌的临床效果

doi:10.20047/j.issn1673-7210.2022.34.20

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Abstract Objective To observe the clinical application effects of total endoscopic Ivor-Lewis surgery in the treatment of middle and lower thoracic esophageal cancer. Methods A total of 165 patients with middle and lower thoracic esophageal cancer were treated in Department of Cardiothoracic Surgery, Jinhua Hospital Affiliated to Zhejiang University School of Medicine from June 2020 to January 2022, and they were divided into group A, group B, and group C by random number table method, with 55 cases in each group. Group A carried out open Ivor-Lewis surgery, group B was treated with total endoscopic Ivor-Lewis surgery, and group C performed total endoscopic Mckeown surgery. The surgical indicators, lymph node dissection, and metastasis were compared among the three groups. The quality of life quotient (QLQ-C30) of patients in the three groups were observed before surgery (T0) and at one month (T1), three months (T2), and six months (T3) after discharge. The postoperative complications and recurrence at six months after surgery were statistically analyzed in the three groups. Results The intraoperative blood loss and postoperative drainage volume in group B and group C were less than those in group A, and the postoperative catheterization time and hospital stay were shorter than those in group A (P＜0.05), and the postoperative drainage volume in group B was less and the postoperative catheterization time and hospital stay were shorter than those in group C (P＜0.05). There were no statistically significant differences in the number of thoracic and abdominal lymph node dissection and metastasis among the three groups (P＞0.05). During T1-T3, the functional field scores of group B were higher than that of group C and group A, the symptom field scores were lower than those of group C and group A, and the health status score was higher than that of group C and group A (P＜0.05). In group B, functional domain scores during T2-T3 were higher than T0, and in group C, functional domain scores at T3 was higher than T0 (P＜0.05). Symptom domain scores during T1-T3 of the three groups were lower than T0, and total health status score was higher than T0 . There were no statistically significant differences in the incidence of postoperative complications and postoperative recurrence rate among the three groups (P＞0.05). Conclusion Total endoscopic Ivor-Lewis surgery is safe and effective in the treatment of middle and lower thoracic esophageal cancer, and it can enhance postoperative quality of life.

Key words： Middle and lower thoracic esophageal cancer Ivor-Lewis surgery Mckeown surgery Total endoscope Complications Quality of life

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	LI Xianshuai CHEN Xianguo HE Shuqian

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LI Xianshuai CHEN Xianguo HE Shuqian. Clinical application of total endoscopic Ivor-Lewis surgery in the treatment of middle and lower thoracic esophageal cancer[J]. 中国医药导报, 2022, 19(34): 85-89.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2022.34.20 OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I34/85

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