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目的比较Ivor-Lewis和Sweet术式在中下段食管鳞癌根治术的应用。方法胸中下段食管鳞癌患者254例分别采用Ivor-Lewis术式(Ivor-Lewis组,102例)和Sweet术式(Sweet组,152例)手术,比较两组淋巴结清扫数量和术后并发症发生情况。结果 Ivor-Lewis组淋巴结清扫总数、上纵隔淋巴结清扫数、腹腔淋巴结清扫数均多于Sweet组(P<0.05),而手术时间短于Sweet组(P<0.05)。Ivor-Lewis组肺部并发症和心律失常发生率均低于Sweet组(P<0.05);两组喉返神经损伤、吻合口瘘、心力衰竭、切口感染发生率差异无统计学意义(P>0.05)。结论 Ivor-Lewis术式对心肺系统干扰较小,对上纵隔及腹腔淋巴结的清扫具有明显优势。
Objective To compare the application of Ivor-Lewis and Sweet technique in the radical operation of esophageal squamous cell carcinoma in the middle and lower segments. Methods 254 patients with lower thoracic esophageal squamous cell carcinoma were treated with Ivor-Lewis technique (102 cases) and Sweet technique (152 cases). The number of lymph node dissection and postoperative complications were compared between the two groups Happening. Results The total number of lymphadenectomy, mediastinal lymph node dissection and abdominal lymph node dissection in Ivor-Lewis group were significantly higher than those in Sweet group (P <0.05), while the operation time was shorter in the Ivor-Lewis group than in the Sweet group (P <0.05). The incidence of pulmonary complications and arrhythmia in Ivor-Lewis group were significantly lower than those in Sweet group (P <0.05). There was no significant difference in the incidence of recurrent laryngeal nerve injury, anastomotic fistula, heart failure and incision infection between the two groups (P> 0.05). Conclusion The Ivor-Lewis procedure has less interference with cardiopulmonary system and has obvious advantages for the dissection of the mediastinum and abdominal lymph nodes.