电视纵隔镜在微创食管癌切除术中应用现状与展望  

Application status and progress of mediastinoscopy in minimally invasive esophagectomy

作　　者：张勇 熊林敏 熊剑文[1] 张小强[1] 喻东亮[1] Zhang Yong;Xiong Linmin;Xiong Jianwen;Zhang Xiaoqiang;Yu Dongliang(Department of Thoracic Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院胸外科,330006

出　　处：《中华胸心血管外科杂志》2021年第2期121-124,共4页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：中央引导地方科技发展专项资金项目(2018ZDG40027)。

摘　　要：中国是食管癌发病率最高的国家之一,近年发病率仍逐年上升。早中期食管癌首选外科手术治疗,如何尽可能完整切除肿瘤,又尽量减少创伤,外科医师一直在探索。近年来,微创手术和腔镜技术的飞速发展,微创食管癌切除术(minimally invasive esophagectomy,MIE)已引领食管癌根治手术的潮流。目前主流的微创术式是经胸电视胸腔镜(video-assisted thoracoscopic surgery,VATS)食管癌切除术,而经胸食管癌切除术需要开胸手术和麻醉塌肺,手术创伤大,术后循环呼吸系统并发症多。避免开胸的电视纵隔镜辅助下食管切除术(mediastinoscopy-assisted esophagectomy,MAE)也是MIE的重要一部分。国外MAE应用起步早,国内开展相对滞缓。本文综述国内不同MAE术式经验,为其在国内的推广提供依据。China is one of the countries with the highest incidence of esophageal cancer,which is still increasing year by year in recent years.Surgical treatment is the first choice for early and middle esophageal cancer.Surgeons have been exploring how to remove the tumor as completely as possible and reduce the trauma as far as possible.In recent years,with the rapid development of minimally invasive surgery and endoscopic technology,minimally invasive esophagectomy(MIE)has led the trend of radical surgery for esophageal cancer.At present,the mainstream minimally invasive surgery is thoracoscopic thoracoscopic(VATS)resection of esophageal cancer,which requires thoracotomy and anesthesia,resulting in large surgical trauma and more complications of postoperative circulatory respiratory system.Mediastinose-assisted esophagectomy(MAE),which eliminates a thoracotomy,is also an important part of MIE.Overseas MAE application started early,but the domestic development is relatively slow.This article summarizes the experience of different MAE surgical methods in China,and provides the basis for its promotion in China.

关 键 词：食管癌切除术 食管切除术 电视纵隔镜 腔镜技术 呼吸系统并发症 外科手术治疗 开胸手术 外科医师 

分 类 号：R735.1[医药卫生—肿瘤]