单操作孔胸腔镜下美蓝染色法精准定位食管小平滑肌瘤的应用  

Application of methylene blue staining for precise positioning of small esophageal leiomyoma during video-assisted thoracoscopic surgery via one utility port

作　　者：张正 廖永德[1] 李阔 黄全福 刘梅[3] 付向宁[1] ZHANG Zheng;LIAO Yongde;LI Kuo;HUANG Quanfu;LIU Mei;FU Xiangning(Department of Thoracic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Sciences and Technology,Wuhan,430030,P.R.China;Department of Thoracic Surgery,Yuhuangding Hospital,Qingdao University Medical School,Yantai,264000,Shandong,P.R.China;Department of Gastroenterology,Tongji Hospital,Tongji Medical College,Huazhong University of Sciences and Technology,Wuhan,430030,P.R.China)

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 [2]青岛大学医学院附属烟台毓璜顶医院胸外科,山东烟台264000 [3]华中科技大学同济医学院附属同济医院消化内科,武汉430030

出　　处：《中国胸心血管外科临床杂志》2018年第9期795-798,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探讨美蓝染色法精准定位食管小平滑肌瘤(<1.5 cm)的可行性。方法 2013年1月至2016年10月同济医院对9例直径<1.5 cm的食管小平滑肌瘤患者行美蓝染色法定位,其中男5例、女4例,平均年龄51岁。术前行胃镜检查,于病变黏膜下注射美蓝0.5~1.0 ml,然后在手术室行单操作孔胸腔镜下食管平滑肌瘤剥除术。结果 9例患者染色过程顺利,单操作孔胸腔镜下探查被染为蓝色的食管床,经染色处均顺利找到食管平滑肌瘤。手术过程顺利,无食管黏膜损伤,无中转开胸,术后行食管碘水造影检查,均无瘘、憩室等并发症出现。结论单操作孔胸腔镜下美蓝染色法可精准定位食管小平滑肌瘤的位置,该方法简单、可行,值得推广应用。Objective To develop a novel methylene blue staining technique to localize small esophageal leiomyomas（〈1.5 cm） and evaluate its feasibility. Methods Between January 2013 and October 2016, 9 patients with small esophageal leiomyomas（〈1.5 cm） underwent thoracoscopic enucleation in Tongji Hospital. There were 5 males and 4 females with an average age of 51 years. We preoperatively injected 0.5–1.0 ml methylene blue in the submucosa adjacent to the tumors under the guidance of gastroscope. Then, we transferred the patients to the operating room.Results Staining was successful in 9 patients. The unstained tumor was exposed after the blue-stained mediastinal pleura and overlying muscle were incised longitudinally during video-assisted thoracoscopic surgery via one utility port. No abnormalities were detected in the esophageal mucosa. No major complications, such as esophageal leakage or esophageal diverticulum occurred. Conclusion Endoscopic methylene blue staining is safe and feasible for localizing small esophageal leiomyomas during video-assisted thoracoscopic surgery via one utility port. This method will enable enucleation precise and easy.

关 键 词：食管平滑肌瘤 美蓝 胸腔镜手术 

分 类 号：R735.1[医药卫生—肿瘤]