Short-term Outcomes Of Ivor-Lewis Operation In Totally Endoscopic Esophagectomy Combined With Jejunostomy

Objectives To explore the clinical applications and value of Ivor-Lewis operation in totally endoscopic esophagectomy combined with jejunostomy.The specific operation steps of Jejunostomy were analyzed.To provide the basis for its clinical application.Methods The clinical data of 80 patients with esophageal cancer were collected and analyzed.30 cases were adopted Ivor-Lewis operation in totally endoscopic esophagectomy combined with jejunostomy.50 cases were performed laparoscopy with abdominal incision combined with thoracoscope esophagectomy.In the aspects of operation time,intraoperative blood loss,time-consuming on placing jejunum nutrition tube,the postoperative hospitalization time,postoperative pain scores,postoperative chest tube and gastrointestinal decompression pipe volume of drainage,perioperative complications such as pulmonary infection and anastomotic fistula,the scores of satisfaction with surgical incisionin cosmesis,two groups were compared.Results The operation time was shorter and intraoperative bleeding loss was remarkably less,the postoperative hospitalization time was obviously shorten,postoperative pain scores,time-consuming on placing jejunum nutrition tube were reduced,the scores of satisfaction with surgical incisionin cosmesis was higher in totally endoscopic esophagectomy group.There was were a significantly difference(P<0.05).In the aspects of number of lymph node dissection,the incidence of secondary open chest or abdomen in order to stanch bleeding,and complications such as anastomotic fistula,pulmonary infection and chylothorax between the two groups,they were not significantly different(P > 0.05).After the postoperative follow-up for 3-9months,no patients died and relapsed,the long-term prognosis was further followed.Conclusion The application of Ivor-Lewis operation in totally endoscopic esophagectomy with jejunostomy could keep the integrity of the abdominal wall,reduce postoperative pain,make the incision scar relatively beautiful,reduce the intraoperative bleeding loss,shorten the postoperative hospitalization days.Safe and effective nutritional supporting through jejunostomy reduce postoperative accident probability of tube drawing.The compliance of patients with jejunostomy is higher than that of duodenal nutrition tube.Ivor-Lewis operation in totally endoscopic esophagectomy combined with jejunostomy is feasible.It could promote further minimally invasive esophageal surgery.