胸腔镜下全食管系膜切除术在食管癌根治术中的应用分析  

The safety and feasibility of thoracoscopic esophagectomy with total meso-esophageal excision for esophageal cancer

作　　者：明炜 吕建发[2] 刘高利[3] 侯国强 胡海峰 龙杏林 张文涵 谢颂平[3] Ming Wei;Lv Jianfa;Liu Gaoli(Department of Thoracic Surgery,Yangxin People's Hospital,Huangshi 435299,China)

机构地区：[1]湖北省阳新县人民医院胸外科,435299 [2]湖北省汉川市人民医院胸外科 [3]武汉大学人民医院胸外科

出　　处：《临床外科杂志》2021年第9期827-829,共3页Journal of Clinical Surgery

摘　　要：目的评价胸腔镜全食管系膜切除术应用于食管癌根治术病人的安全性、可行性及短期疗效。方法2018年9月~2021年6月收治的行胸腹腔镜食管癌根治术病人143例。按照胸腔镜下食管游离方式的不同分为两组,常规游离组62例,在腔镜下行食管常规游离;全食管系膜切除游离组81例,在腔镜下采用食管全系膜切除术。结果全组手术切缘均为阴性,R0切除率均为100%,无死亡和切口相关并发症发生,术后并发症的总体发生率为24.47%;虽然全系膜切除切除范围增加,与常规食管游离组比较,全食管系膜切除组的胸腔出血量有所减少,胸部手术时间增加并不明显,淋巴结清扫数目增加;两组术后并发症并发症发生率比较差异无统计学意义。结论胸腔镜下全食管系膜切除术应用于食管癌根治术安全可行,近期效果满意。Objective To evaluate the safety,feasibility and short-term efficacy of laparoscopic Laparoscopic Mesangial full excisionfor patients with esophageal cancer.Methods Retrospective analysis was performed on the clinical data of 143 patients with esophageal cancer who underwent the thoracoscopic McKeown esophago-gastrectomy from September 2018 to June 2021.According to the different modes of esophageal dissociation under thoracoscopy,the patients in the conventional dissociation group were divided into two groups.Total esophageal mesangectomy was performed in 81 cases of free group.Results All surgical margins were negative,R0 resection rate was 100%,no death and incision related complications occurred,and the overall incidence of postoperative complications was 24.47%.Total meso-esophageal excision showed an advantages of lymph node dissection,similar results regarding the bleeding,and time consuming of thoracic operation,compared to non-ME group.There were no statistically significant differences between the 2 groups in terms of postoperative complications.Conclusion Laparoscopic Esophageal Mesangial full excisionfor is safe and feasible for elderly patients with esophageal cancer,and the short-term results are satisfactory.

关 键 词：食管癌 胸腹腔镜 微创食管切除术 全食管系膜切除术 

分 类 号：R735.1[医药卫生—肿瘤]