保留迷走神经的腹腔镜食管切除胃代食管术  

Laparoscopic vagal-sparing esophagogastrectomy

作　　者：龚太乾[1,2] 李孟彬[2] 刘小南[2] 孙力[2] 杨帆[1] 王如文[1] 蒋耀光[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军胸外科研究所,重庆400042 [2]第四军医大学西京消化病医院消化外科,西安710032

出　　处：《中华消化外科杂志》2013年第10期742-745,共4页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（81071976、8110891、81372556）;军队医院临床高新技术重大项目（2010gxjs073）

摘　　要：腹腔镜保留迷走神经的食管切除胃代食管术治疗早期食管癌具有微创、功能保全和术后生命质量好的优势，同时能达到常规根治性手术的肿瘤学效果。2009年9月至2013年8月第三军医大学大坪医院和第四军医大学西京消化病医院对12例早期食管黏膜内鳞癌患者施行保留迷走神经的食管切除胃代食管术。术后随访1～24个月，其中发生一过性声音嘶哑和颈部吻合口瘘各1例，经保守治疗治愈；术后2个月吻合口狭窄1例，经扩张治疗3次后治愈；其余患者均能正常经口进食，无胸闷、腹胀、腹泻、吞咽困难等症状，无肿瘤复发、转移征象。因此，腹腔镜保留迷走神经食管切除胃代食管术是治疗早期食管黏膜内癌和食管良性疾病的较好选择。Laparoscopic vagal-sparing esophagogastrec tomy for the treatment of early esophageal cancer has the advan tages of minimal invasion, functional sparing and better quality of life, and it can radically resect the tumor. The clinical data of 3 patients in the Daping Hospital of Third Military Medical Uni versity and 9 patients in the Xijing Hospital of Digestive Diseases who received laparoscopic vagal-sparing esophagogastrectomy from September 2009 to August 2013 were retrospectively ana lyzed. All the 12 patients were followed up for 1-24 months. One patient was complicated with transit hoarseness and 1 with cervical anastomotic fistular, and they were cured by conservativetreatment; 1 patient was complicated with cervical anastomotic stricture, and was cured by dilatation for 3 times; no dysphagia and recurrence was observed in the other 9 patients during the follow-up. Laparoscopic vagal-sparing esophagogastrectomy is a good option for early esophageal cancer and benign esophageal diseases.

关 键 词：食管肿瘤 腹腔镜检查 食管切除术 保留迷走神经 

分 类 号：R735.1[医药卫生—肿瘤]