胸腔镜下颈、胸、腹三切口食管癌根治术的手术配合  

The Cooperation for Esophagus Radical Operation with Three Incisions on Neck,Thorax and Abdomen under Thoracic Endoscope

作　　者：卢秀英[1] 黄静[1] 江小芳[1] 

机构地区：[1]四川省肿瘤医院手术室,成都610041

出　　处：《肿瘤预防与治疗》2012年第4期259-262,共4页Journal of Cancer Control And Treatment

摘　　要：目的:总结胸腔镜下颈、胸、腹三切口食管癌根治术的手术配合经验。方法:对59例经上腹、右胸、左颈行胸腔镜下食管癌根治术的手术前准备、术中配合要点及患者术后恢复情况进行分析,总结腔镜下三切口行食道癌的手术配合要点。结果:全组59例患者,51例患者在胸腔镜下完成手术,8例中转开胸;手术时间平均250(180～330)min,其中胸部手术时间平均为100(80～120)min;术中估计出血量平均150(100～200)ml;术后胸腔引流管放置时间为2天～4天(平均3天);住院时间为9天～10天。51例患者无围手术期死亡,无吻合口瘘、乳糜胸;术后并发心律失常1例、声嘶2例、肺部感染2例,全组并发症发生率占9.8%。结论:术前精心准备,术中密切配合,熟练掌握腔镜器械使用和维护以及术中注意无菌技术操作和无瘤技术,是配合此类手术成功的关键。Objective： To summarize the experience of the cooperation for esophagus radical operation with three incisions on neck, thorax and abdomen under thoracic endoscope. Methods： The pre-operation preparation, cooperation tips and post-operation re- covery of 59 esophagus carcinoma patients who underwent radical operation with three incisions on left neck, right thorax and upper ab- domen under thoracic endoscope were analyzed, and the main points of cooperation were summarized. Results： In the 59 cases, 51 eases accomplished the operation under thoracic endoscope, whereas 8 cases changed to open chest operation. The average operating time was 250 （180 N 330）min, in which the thoracic operating time was 100 （80 - 120）min; The average estimated blood loss was 150 （100 200） ml ; The post-operative thoracic drainage time was 2 - 4 （ average 3 ） days ; The in-hospital day was 9 - 10d. The 51 cases had no peri-operation mortality, no anastomotic fistula and no chylothorax. One case complicated arrhythmia postoperatively, 2 cases tra- chyphonia and 2 cases pneumonia infection, with a complication rate of 9.8% in the whole group. Conclusion： The fine preparation before operation, intimate cooperation, using and maintaining endoscope equipments proficiently and the attention to aseptic and free- tumor technique in operation are the key points for the success of these kinds of operation.

关 键 词：食管肿瘤 食管切除术 胸腔镜 手术中护理 

分 类 号：R472.3[医药卫生—护理学]