227华西医学 2013, 28（2）West China Medical Journal, Vol.28, No.2 Feb. 2013
食管癌Ivor-Lewis术式中施行腹腔镜
胃微创游离的应用
罗仕云，李文忠，吴坚，师路，何家杰，陈浩林，李毅
跑外勤后的真实感受
【摘要】 目的 探讨腹腔镜胃微创游离术在食管癌Ivor-Lewis术式的应用价值。方法 回顾性分析2009年4月－2011年1月行Ivor-Lewis术式食管癌患者25例，其中男15例，女10例，年龄50～72岁，平均63岁，食
管中段癌14例，食管下段癌11例，腹部操作均采用经脐部、右腋前线平胆囊底水平、左腋前线平左侧肋缘及前述
两操作孔与脐部连线中点做操作孔置入腹腔镜器械，超声刀游离胃并清扫腹腔淋巴结。结果 25例手术均取得成
功，无中转开腹。腹腔镜操作时间30~80 min；出血约2~20 mL，无术中输血；行胃左动脉、肝总动脉、腹腔干动脉、
结了婚的女人
胃大、小弯及贲门旁淋巴结完全清扫，术后患者2～4 d肛门排气，术后5～7 d恢复进食，术后住院9～12 d ；25
例患者随访1～2年，进食及生活质量良好，无复发转移及死亡者。结论 食管癌Ivor-Lewis术式中采用腹腔镜胃
微创游离术是安全可行的，可充分游离胃、腹腔淋巴结清扫彻底同时具有减少手术创伤、出血少、疼痛轻、术后并发
症少、住院时间减少等优点，值得推广。
【关键词】 食管癌；Ivor-Lewis术式；腹腔镜；胃微创游离
【文献标识码】 A DOI:10.7507/1002-0179.20130072
Laparoscopic Gastric Mobilization in Ivor-Lewis Esophagectomy for Esophageal Cancer LUO Shi-yun, LI Wen-
zhong, WU Jian, SHI Lu, HE Jia-jie, CHEN Hao-lin, LI Yi. Department of Thoracic Surgery, No. 363 Hospital of Chengdu,
Chengdu, Sichuan 610041, P. R. China
Corresponding author: LI Wen-zhong, E-mail:
【Abstract】 Objective To evaluate the clinical value of laparoscopic gastric mobilization in Ivor-Lewis esophagectomy. Methods Between April 2009 and January 2011, the clinical data of 25 cas of esophageal carcinoma
were retrospectively reviewed (including 15 males and 10 females aged from 50 to 72 years old with an average of 63).
There were 14 patients with middle esophageal carcinoma and lower esophageal carcinoma was in 11. Five trocars were电子商务职业
inrted through the umbilicus, the right anterior axillary line within the gallbladder bottom level, the left anterior axillary
line within the left rib edge level, or at the junction of the midpoint between the aforementioned two operations hole and
the umbilical. We ud the ultrasonic scalpel to free stomach and disct abdominal lymph nodes. Results Laparoscopic
gastric mobilization in Ivor-Lewis esophagectomy were performed successfully in 25 cas of esophageal carcinoma without
中秋节的诗conversion to open surgery, and the operation time was 30-80 minutes, the blood loss was 2-20 mL without intraoperative
blood transfusion. The lymph nodes of the left gastric artery, hepatic artery, celiac artery, the greater and lesr curvature of
stomach and cardia were completely rected. The time of anus exhaust was 2-4 days, and patients resumed eating 5-7 days
after the operation. The postoperative hospital stay was 9-12 days. All patients were followed up with 1-2 years, enjoying
a good quality of life; no tumor recurrence or metastasis and postoperative death were found. Conclusions Laparoscopic
gastric mobilization in Ivor-Lewis esophagectomy is safe and feasible, which should be promoted. Becau stomach can be
fully freed and at the same time abdominal lymph nodes can be completely discted with the advantages of fewer surgical
trauma, less hemorrhage, less pain, fewer postoperative complications and shorter hospital stay, etc.
【Key words】 Esophageal carcinoma ; Ivor-Lewis; Laparoscopy; Gastric mobilization
论 著
【作者单位】成都三六三医院胸外科（成都，610041）
【作者简介】罗仕云（1979－），男，四川泸州人，主治医师，本科，E-mail：
苏州有哪些园林
【通讯作者】李文忠，E-mail：
【网络出版时间】 2013-02-06 18:30天上的街市赏析
步字组词
【网络出版地址】 wwwki/kcms/detail/51.1356.R.20130206. 1830.032.html
新疆阿魏1991年Collard等[1]首先将腔镜技术用于食管癌手术。受到技术条件及水平的限制，发展缓慢，腔镜技术特别是胸外科医生“相对薄弱”的腹腔镜操作技术还没得到广泛开展，但腔镜手术因微创、出血少、疼痛轻、术后并发症少、住院时间短等优点，逐渐为
