Comparative analysis of the efficacy of radical esophagectomy(thoracoscopy)and Ivor-Lewis(thoracoscopy)for patients with locally advanced esophageal squamous cell carcinoma through left cervical-right thoracic-abdominal three incisions
Objective:To compare the efficacy of radical resection for locally advanced esophageal squamous cell carcinoma through three incisions(left cervical,right thoracic,and abdominal)(thoracoscopic surgery)and two incisions(abdominal and thoracic)(Ivor-Lewis esophagectomy)(thoracoscopic surgery).Methods:A total of 100 patients with locally advanced esophageal squamous cell carcinoma diagnosed in our hospital from May 2018 to May 2023 were selected as the research subjects.They were divided into a control group and a research group according to the treatment plan,with 50 cases in each group.The control group received thoracoscopic-laparoscopic combined Ivor-Lewis surgery,while the research group received thoracoscopic-laparoscopic combined left cervical-right chest-abdominal three-incision radical esophagectomy.Surgical indexes and complication status,as well as perioperative immune function,stress response[C reactive protein(CRP),cortisol(Cor)],and intestinal function(diamine oxidase,D-lactate)were compared between the 2 groups.Results:Compared with the control group,the study group had significantly less hospitalization time,intraoperative blood loss,first meal time,and operation time,and significantly more lymph node dissection(P<0.05).Three days after surgery,the serum levels of diamine oxidase,D-lactate,CRP,and Cor in the study group were significantly lower than those in the control group(P<0.05);the CD4+,CD4+/CD8+in the study group were significantly higher than those in the control group(P<0.05).The incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion:Compared with thoracoscopic and laparoscopic combined with Ivor-Lewis surgery,thoracoscopic and laparoscopic combined with left cervical-right chest-abdominal three-incision radical resection for the treatment of locally advanced esophageal squamous cell carcinoma patients has significant effects,which can improve surgical outcomes,promote intestinal function recovery,reduce stress response,have less impact on immune function,and ensure surgical safety.
Esophageal cancerSquamous cell carcinomaThoracic laparoscopyRadical resection of esophageal carcinomaNotch
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