摘要目的 对比研究全腔镜Ivor-Lewis食管癌切除及空肠造瘘术与腔镜联合上腹部小切口同类手术的近期疗效与并发症发生率.方法 回顾分析2017年1月至2018年7月我科同-治疗组完成食管中下段癌根治术160例临床资料,其中79例在无腹部小切口全腔镜下完成Ivor-Lewis食管癌切除及空肠造瘘术(全腹腔镜组),81例在腔镜联合上腹部小切口下完成Ivor-Lewis食管癌切除术并同期置入鼻肠管(腹部小切口组).比较分析两组术前、术中、术后部分临床指标及并发症发生情况.结果 两组手术时间、术中出血量、淋巴结清扫数量、术后引流量、手术总费用差异无统计学意义.两组术后3天疼痛评分、切口并发症、肺部感染率、术后住院日有统计学意义(P＜0.05).结论 全腹腔镜Ivor-Lewis食管切除术具有更好的近期疗效,值得临床推广应用.

abstractsObjective Comparative study on efficacy and complications between totally laparo-thoracoscopic Ivor-Lewis esophagectomy(LTILE)combined with jejunostomy,and esophagectomy with assisted abdominal incision.Methods Clinical data of 160 patients with mid-lower thoracic esophageal cancer who underwent thoracoscopic laparoscopic oesophagectomy within the same therapeutic group from January 2017 to July 2018 were retrospectively analyzed.79 patients underwent totally LTILE combined with jejunostomy;the rest 81 patients had LTILE with assisted abdominal incision and nasointestinal tube placement.Preoperative,intraoperative and postoperative clinical data and complicatioos were analyzed.Results There was no significant difference between two groups,including operation time,intraoperative blood loss,number of lymph nodes dissection,postoperative drainage and total treatment cost.In terms of the postoperative pain scores within 3 days,incision complications,pulmonary infection rate and postoperative hospitalization time,there were significant differences(P ＜ 0.05).Conclusion Complete LTILE with jejunostomy appeared to render better short-term clinical outcomes.