Abstract: Objective:To compare the effects of total laparoscopic IvorLewis surgery and laparoscopic combined with small upper abdominal incision IvorLewis surgery on stress response and gastrointestinal function in patients undergoing radical esophagectomy.Methods:The clinical data of 86 patients with radical esophagectomy in middle and lower esophagus treated in our hospital from January 2017 to April 2019 were retrospectively analyzed.According to the surgical method,they were divided into the total endoscopic group(46 cases,full endoscopic IvorLewis Surgery) and laparoscopic combined incision group(40 cases,IvorLewis operation combined with laparoscopic combined small incision in upper abdomen).The difference of operation index,complication,stress index,gastrointestinal function index and prognosis between the two groups were compared.Results:The postoperative hospital stay(12.2±2.4)d and the first postoperative exhaust time(2.8±1.2)d in the full endoscopic group were shorter than those in the endoscopic combined incision group[(14.6±2.6)d,(3.9±1.4)d](P＜0.05).There were no significant differences in hospitalization expenses,intraoperative blood loss,operation time,and the number of lymph node dissections between the two groups(P>0.05).After surgery,the MDA of the total endoscopic group was (7.90±2.26)μmol/L,which was lower than that of the combined incision group[(9.29±2.78)μmol/L,P＜0.05].SOD of the total endoscopic group was(73.62±7.54)U/L,motilin was (124.11±11.00)ng/L,gastrin was(64.22±6.82)ng/L,which was higher than the endoscopic combined incision group[(62.97±6.46)U/L,(100.51±11.78)ng/L,(51.11±5.59)ng/L](P＜0.05).There was no significant difference in recurrence rate(13.9% vs.10.8%),metastasis rate(9.3% vs.8.1%) and mortality(4.6% vs.2.7%) between the two groups(P>0.05).Conclusion:IvorLewis surgery has the advantages of fast recovery,and little effect on gastrointestinal function and stress response.The shortterm effect is remarkable.

Key words: holoscope, IvorLewis operation, radical esophagectomy, stress response, gastrointestinal function, prognosis