腔镜辅助胃上徙胃代食管胃咽吻合术4例报告  

Application of gastric pharyngeal anastomosis assisted by laparoscope and a report of 4 cases

作　　者：林庆海[1] 王挥戈[1] 林心强[1] 严江[2] 杨填[2] 

机构地区：[1]汕头大学医学院第一附属医院耳鼻咽喉头颈外科,广东汕头515041 [2]汕头大学医学院第一附属医院普外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2015年第9期821-823,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：2013年汕头市科技计划项目

摘　　要：目的:探讨腔镜辅助胃代食管胃咽吻合术在修复晚期下咽及颈段食管癌切除后咽环周缺损的临床应用。方法:在4例晚期下咽及颈段食管癌根治术后,采用腹腔镜技术代替传统开腹(开胸)的开放进路,同期行胃上徙胃代食管胃咽吻合术。结果:4例患者均成功行经腹腔镜辅助胃上徙胃代食管胃咽吻合术,均避免了开胸或开腹手术。1例术后出现咽瘘,半年后死亡。1例1年半后颈部淋巴结转移,因经济问题未再行治疗。2例仍存活,1例术后已3年半,1例术后已2年半。结论:腔镜辅助胃代食管胃咽吻合术确实可行,创新和改良了传统粗放的开放术式,可显著减轻手术创伤,提高手术安全性,提高患者术后的生存质量。Objective：To explore the clinical application of gastric pharyngeal anastomosis assisted by laparo- scope. Method：Apply laparoscope in the gastric pharyngeal anastomosis for 4 cases of advanced hypopharyngeal carcinoma and cervical esophageal carcinoma patients. Result： Gastric pharyngeal anastomosis assisted by laparo- scope were successfully completed in all 4 patients, all patients avoided thoracotomy or laparotomy,one patient oc- curred pharyngeal fistula,and died six months later. One patient had cervical lymph node metastasis a year and a half later,without treatment again because of economicissue. The remaining two patients were still alive, one patient had survived 3 years and a half after operation,the other had survived 2 years and a half after operation. Conclusion：Gastric pharyngeal anastomosis assisted by laparoscope is feasible. It can reduce the operation wound,improve the safety of operation and patients＂ life quality.

关 键 词：下咽癌 颈段食管癌 腹腔镜 胃咽吻合术 

分 类 号：R739.63[医药卫生—肿瘤] R735.1[医药卫生—临床医学]