Ivor-Lewis手术治疗食管癌临床疗效研究.doc

Ivor-Lewis手术治疗食管癌临床疗效研究 【摘要】目的 对比分析改良和传统Ivor-Lewis手术治疗食管癌的疗效，为临床治疗过程中术式的选择提供参考和借鉴。方法 回顾性我院150例食管癌患者的临床资料，对比分析传统Ivor-Lewis手术和改良Ivor-Lewis手术的治疗效果。结果 观察组近期疗效明显优于对照组（P＜0.05），远期疗效比较差异无统计学意义（P＞0.05）。结论 改良Ivor-Lewis手术辅之以腹腔镜是治疗食管癌安全有效的微创手术，极大程度减轻患者术后的疼痛感，减少或者避免术后并发症的发生，有效的促进患者术后生活质量的提高，值得在临床上广泛的推广和应用，但是在实践过程中一定要严格掌握其手术适应证，确保手术安全有效。 【关键词】食管癌；Ivor-Lewis手术；疗效；腹腔镜 Ivor-Lewis operation for esophageal cancer clinical research [Abstract] Objective To compare the efficacy of modified and conventional Ivor-Lewis operation in the treatment of esophageal carcinoma, and provide the reference for the clinical treatment of choice of operation. Methods Rretrospectively in our hospital, the clinical data of 150 cases of esophageal carcinoma, comparative analysis of curative effect of traditional Ivor-Lewis operation and modified Ivor-Lewis operation. Results The curative effect of observation group was better than that of control group (P 0.05), no significant difference (P 0.05) long-term efficacy. Conclusion The clinical use of modified Ivor-Lewis operation and assisted by laparoscopy is safe and effective minimally invasive operation in treatment of esophageal cancer, greatly reduce postoperative pain, reduce or avoid the occurrence of postoperative complications, and effective for patients with improved quality of life, worthy of extensive promotion and application in clinical, but in the process of practice must adapt to the uncle mastered strictly, to ensure the safety and effectiveness of operation. [keyword] Esophageal Carcinoma; Ivor-Lewis operation; Curative effect; Llaparoscopic; 根据流行病学调查研究资料显示，我国食管癌是一种常见的恶性肿瘤，好发于食管中段，其发病率以及死亡率呈现逐年上升的趋势[1]。目前对于食管癌的治疗手段只要以手术切除为主，传统Ivor-Lewis手术创伤较大，术后并发症发生率以及死亡率均较高，手术适应证较窄，患者的依从性较差。随着腹腔镜技术不断发展且普遍应用于临床，对于食管癌的手术治疗提出了新的要求。目前，腔镜主要包括电视胸腔镜、腹腔镜、纵膈镜，在其辅助下行Ivor-Lewis手术微创、出血量小、术后疼痛轻、并发症以及死亡率低等优势受到广大医师和患者的认可青睐[2]。本研究选择我院2009年3月到2011年8月期间收治的150例食管癌患者为研究对象，对比分析传统Ivor-Lewis手术和改良Ivor-Lewis手术的适应证已经治疗效果，以期为今后临床手术治疗食管癌寻求更可靠且效果显著的术式，为医师在治疗过程中确