摘要
目的探讨微创荷包钳法MIILE术治疗中下段食管癌的临床疗效及预后影响因素分析。方法选取2015年3月至2018年2月间安康市人民医院收治的112例中、下段食管癌患者,根据手术方式分组。采用微创lvor-Lewis(MIILE)术治疗的60例患者纳入观察组,采用微创McKeown(MIME)术治疗的52例患者纳入对照组。探讨不同方案治疗中下段食管癌的临床疗效,并分析中下段食管癌的预后影响因素。结果观察组患者手术时间、术中出血量、术后住院时间和术后放管时间均低于对照组,差异均有统计学意义(均P<0.05)。两组患者淋巴结清扫和住院费用比较,差异无统计学意义(P>0.05)。观察组患者吻合口或管胃瘘、肺部感染和喉返神经损伤发生率均低于对照组,差异均有统计学意义(均P<0.05)。两组患者手术切口感染、吻合口狭窄和乳糜胸发生率比较,差异无统计学意义(P>0.05)。单因素分析显示,患者年龄、分化程度、肿瘤浸润深度、临床分期、淋巴结转移数目和淋巴结转移区域数与预后有关(P<0.05);患者性别、肿瘤部位、肿瘤长度与预后无关(P>0.05)。COX回归分析发现,肿瘤浸润深度、分化程度、淋巴结转移数目和淋巴结转移区域数对患者预后有影响(均P<0.05)。结论微创荷包钳法MIILE术治疗中下段食管癌手术时间短,术后恢复较快,并发症发生率低于MIME术,安全可靠。淋巴结转移是患者预后主要影响因素。
Objective To investigate the efficacy of minimally invasive Ivor-Lewis esophagectomy(MIILE)in the treatment of middle and lower esophageal cancer and analyze factors influencing the prognosis of patients.Methods A total of 112 patients with middle and lower esophageal cancer admitted to Ankang People's Hospital were selected from March 2015 to February 2018 and divided according to different surgical methods.Sixty patients undergoing MIILE were included in an observation group and 52 patients undergoing minimally invasive Mc Keown esophagectomy(MIME)were included in a control group.Clinical efficacy was investigated and factors influencing the prognosis were analyzed.Results The duration of operation,intraoperative blood loss,postoperative length of hospital stay,and postoperative duration of tube placement time were significantly lower in the observation group than in the control group(all P<0.05).However,no difference was found in the lymph node dissection and hospitalization costs between the two groups(P>0.05).The incidence of anastomotic or tuberculous fistula,pulmonary infection and recurrent laryngeal nerve injury was significantly lower in the observation group than in the control group(all P<0.05).No difference was found in the incidence of surgical incision infection,anastomotic stenosis,and chylothorax between the two groups(P>0.05).Univariate analysis showed that prognosis was associated with age,degree of differentiation,depth of tumor invasion,clinical stage,number of lymph node metastasis,and distribution of lymph node metastasis(all P<0.05)rather than with gender,tumor location,and tumor length(P>0.05).COX regression analysis showed that depth of tumor invasion,degree of differentiation,number of lymph node metastasis and distribution of lymph node metastasis had significant effects on the prognosis of patients(all P<0.05).Conclusion Compared with the MIME,MIILE has the advantages of short duration of operation,faster recovery,low incidence of complications in middle and lower esophageal cancer pa
作者
王从和
杜加原
成勇
WANG Cong-he;DU Jia-yuan;CHENG Yong(Department of Thoracic Surgery,Ankang People's Hospital,Ankang 725000,China;Department of Surgery,Ankang People's Hospital,Ankang 725000,China)
出处
《中国肿瘤临床与康复》
2021年第8期974-977,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
MIILE术
MIME术
中下段食管肿瘤
预后
疗效
Minimally invasive Ivor-Lewis esophagectomy
Minimally invasive Mc Keown esophagectomy
Middle and lower esophageal neoplasms
Prognosis
Efficacy
