食管癌微创手术下胃食管吻合方式的应用进展  

Progress in the application of gastroesophageal anastomosis via minimally invasive esophagectomy

作　　者：何晓峰[1] 成强 喻傲 王涛[1] 史敏科[1] He Xiaofeng;Cheng Qiang;Yu Ao;Wang Tao;Shi Minke(Department of Thoracic Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院胸外科,南京210008

出　　处：《中华胸部外科电子杂志》2022年第1期41-45,共5页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

基　　金：南京市医学重点科技发展项目(ZKX18019)。

摘　　要：食管癌切除术仍然是目前治疗食管癌的首选方式,随着胸腹腔镜在食管癌手术中的广泛应用,食管癌的手术方式在变化,胃食管吻合方式也有所变化,吻合技术也在不断改进,因此有必要对食管癌微创手术时代下的胃食管吻合技术特点作归纳总结。不管是在颈部吻合还是在胸内吻合,关于手工吻合和器械吻合的优劣争论从未停止过,新的吻合方式和技巧也在不断研究改进中,好的吻合方式在尽量降低吻合口并发症的前提下,还需要操作简单可重复性强,以便外科医生容易掌握和推广。由于目前缺乏简单安全可靠的腔镜下胸内吻合方式,微创Ivor-Lewis术式的推广受到了限制,所以对于腔镜下的胸内吻合方式的研究将会是未来胃食管吻合方式研究中的重点。胸外科医生应致力于开发新的吻合方法或吻合器械来使吻合操作更简单化、更易于推广。Esophagectomy is still the first choice for the treatment of esophageal cancer.With the wide application of thoracoscopy and laparoscopy in esophagectomy,the surgical methods of esophagectomy,the way of gastroesophageal anastomosis,and the anastomotic techniques are changing.In view of this,it is necessary to summarize the technical characteristics of gastroesophageal anastomosis in the era of minimally invasive surgery for esophageal cancer.The debate on the pros and cons of hand-sewn and mechanical gastroesophageal anastomosis whether in the neck or in the chest has never stopped.New anastomosis methods and techniques are also being studied and improved.On the premise of minimizing anastomotic complications,good anastomosis methods also need to be simple and repeatable,so that surgeons can easily master and popularize them.Currently,due to the deficiency of simple,safe and reliable endoscopic thoracic gastroesophageal anastomosis,the promotion of the minimally invasive Ivor-Lewis is limited.Therefore,research on endoscopic intrathoracic anastomosis will be the focus of future gastroesophageal anastomosis research.Thoracic surgeons should work on developing new anastomotic methods or instruments to make gastroesophageal anastomosis easier to scale.

关 键 词：食管癌 微创食管切除术 胃食管吻合 消化道重建 

分 类 号：R735.1[医药卫生—肿瘤]