目的：观察左胸和右胸入路治疗胸中段食管癌的疗效。方法：106例食管癌患者随机分成两组，观察组：采取右胸入路的Ivor-Lewis术式治疗；对照组：采取经左胸食管癌切除胃食管弓上吻合术进行手术治疗，比较两组患者的术后并发症、术后恢复情况、术中引流情况和淋巴结清除等等指标，判定两种术式的优缺点。结果：对照组的患者手术失血量显著低于观察组，观察组患者手术时间显著长于对照组，P＜0.05。其余指标，切除淋巴结个数、术后首日胸腔引流量、术后总引流量、阳性淋巴结个数、术后引流时间两组均无显著差异，P＞0.05。观察组患者的并发症显著高于对照组，P＜0.05。两组死亡率比较无差异。两组患者五年生存率和三年复发情况无差异，对照组的无复发生存时间长于观察组，P＜0.05。结论：两种手术入路的术后生存率以及围手术期指标相比差别不大，但Ivor-Lewis术式能显著降低患者术后不良反应提高无复发生存率。%[ABSTRACT]Objective: To observe the curative effect of the treatment of thoracic esophageal carcinoma with left and right thoracic approach. Methods: 106 patients with esophageal carcinoma were randomly divided into two groups. The observation group was treated with Ivor-Lewis operation. The control group was treated with left breast resection of esophageal carcinoma, and compared with two groups of patients with postoperative complications, postoperative recovery, drainage and lymph node clearance. Results: The operation time of the patients in the control group was signiifcantly lower than that in the observation group, the operation time of the observation group was signiifcantly longer than that of the control group, P<0.05. The other indicators, the number of lymph nodes, the number of the ifrst day after operation, the total lfow rate, the number of positive lymph nodes, and the drainage time of the two groups were not signiifcantly different, P>0.05. The complication of the observation group was signiifcantly higher than that of the control group, P<0.05. There was no difference in mortality between the two groups. The ifve year survival rate of the two groups was no different from the three year recurrence, the recurrence free survival time in the control group was longer than that in the observation group, P<0.05. Conclusion:Two kinds of surgical approaches have little difference, but Ivor-Lewis can signiifcantly reduce the postoperative adverse reactions and improve the recurrence free survival.
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