全胸腔镜下食管胃胸内吻合术治疗食管癌的初步探讨  

Primary discussion of thoracoscopic thoracic esophagus-gastric anastomosis for treatment of esoph- ageal carcinoma

作　　者：艾波[1] 廖永德[1] 付向宁[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胸外科,武汉430030

出　　处：《临床外科杂志》2013年第7期527-529,共3页Journal of Clinical Surgery

摘　　要：目的探讨全胸腔镜下食管胃胸内吻合术微创治疗中下段食管癌的方法及可行性。方法10例食管癌患者行全胸腔镜下食管胃胸内吻合术运用普通胃肠吻合器（强生管型吻合器）行食管胃右胸内吻合以重建消化道，并腔镜下行吻合口减张缝合及大网膜包埋。结果无中转开胸，手术时间290—350min，其中胸腔镜胸部操作时间190—220min，术中平均出血375ml，清除淋巴结共计201枚，平均20．1枚／例；无围手术期死亡，术后胸部疼痛感轻，早期即可下床活动，术后（13±3）d顺利出院，无吻合口瘘。随访3个月～6个月，无死亡，无复发。结论全胸腔镜下食管胃胸内吻合术微创治疗中下段食管癌可行，微创效果满意，值得推广。Objective To explore the methods and feasibility of thoracoscopic thoracic esopha- gus-gastric anastomosis for treatment of middle and lower esophageal cancer. Methods Ten patients with middle and lower esophageal cancer underwent thoracoscopic thoracic esophagus-gastric anastomosis. Common gastrointestinal anastomat was used in digestive tract reconstruction. Reduced tension sutures and greater omentum embedding were performed under the thoracoscope. Results No case was converted to the open esophagectomy. The total operation time ranged from 290 to 350 minutes, and the VATS time ranged from 190 to 220 minutes. The mean operative blood loss was 375 ml. A total of 201 lymphnods were removed （20.1 per patient in average）. No patient died during the perioperative period. The postoperative pain was light and the patients could leave bed at early stage. All patients discharged from the hospital after 13±3 d. No anastomotic leak occurred. All of the patients received a follow-up for 3 to 6 months. No death and recurrence happened. Conclusion The thoracoscopic thoracic esophagus-gastric anastomosis is feasi-ble for treatment of middle and lower esophageal cancer. It has less trauma and is worthy of spreading.

关 键 词：胸腔镜 胸内吻合术 食管癌 微创手术 

分 类 号：R735.1[医药卫生—肿瘤]