Clinical application of Ivor-Lewis combined with thoracic-laparoscopy for esophageal carcinoma resection in patients with esophageal lowest cancer

Abstract

Objective To study the clinical application effect of Ivor-Lewis combined with thoracic-laparoscopy for esophageal carcinoma resection in patients with esophageal lowest cancer. Methods A total of 68 patients with esophageal lowest cancer were individed into the observation group and control group by the random number method, each of 34 cases. The patients in the observation group received Ivor-Lewis combined with thoracic-laparoscopy, and the patients in the control group received intrathoracic esophagogastrostomy by left chest posterolateral incision, then to compare the differences of clinical effect and complications. Results The operation time, blood loss in-operation, in-hospital time, thoracic drainage after operation in the observation group were all significantly less than those of the control group [operation time:(165.3±53.7)vs(214.3±71.5)min,t=3.814,P=0.037;blood loss in-operation:(153.6±23.1)vs (312.3±48.6)min,t=3.413,P=0.042;in-hospital time:(7.4±1.2)vs(10.5±2.3)d,t=3.256,P=0.043;thoracic drainage after operation:(635.6±34.2)vs(831.3±45.6)mL,t=2.594,P=0.039]. The total rate of complications including pulmonary infection, gastric emptying, anastomotic fistula and diaphragmatic hernia and the recurrence rate after 6 months including recurrence in situ, lymph node and hematogenous metastasis were all significantly lower in the observation group(complication:17.65%vs 38.24%,χ2=4.012,P<0.001;recurrence:20.59%vs 47.06%,χ2=4.825,P <0.001). Conclusion Ivor-Lewis combined with thoracic-laparoscopy for esophageal carcinoma resection in patients with esophageal lowest cancer is safe and effective. Key words: Lvor-Lewis; Thoracic-laparoscopy; Esophageal carcinoma; Lowest cancer