单一体位双两孔法食管癌切除食管胃颈部吻合术疗效观察  

Observation of curative effect of single-position double-two-port esophagectomy and cervical anastomosis for treatment of esophageal cancer

作　　者：程纪伟 马海波 刘宝兴 邢文群 CHENG Ji-wei;MA Hai-bo;LIU Bao-xing;XING Wen-qun(Department of Thoracic Surgery,Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital,Zhengzhou 450008,China)

机构地区：[1]郑州大学附属肿瘤医院,河南省肿瘤医院胸外科,郑州450008

出　　处：《医药论坛杂志》2022年第20期27-31,共5页Journal of Medical Forum

摘　　要：目的 探讨单一体位双两孔法(两孔胸腔镜+两孔腹腔镜)食管癌切除食管胃颈部吻合术治疗食管癌的可行性。方法 2022年3月至2022年5月河南省肿瘤医院胸外科共进行14例单一体位双两孔法食管癌切除食管胃颈部吻合术(男8例,女6例,年龄45~69岁),其中胸上段3例,胸中段10例,胸下段1例。所有病例术前均经病理诊断为鳞状细胞癌。患者采用左侧卧位后倾45°体位,两孔胸腔镜游离胸段食管及淋巴结清扫,两孔腹腔镜游离胃及腹腔淋巴结清扫,制作管胃,管胃-食管左侧颈部吻合术。结果 所有患者均顺利完成单一体位双两孔法食管癌切除食管胃颈部吻合术,平均胸腔操作时间136 min,腹腔手术操作时间平均53 min,手术总时间平均228 min,术中出血量35~210 mL(平均70 mL),术后住院时间9~15 d(平均11 d)。结论 单一体位双两孔法食管癌切除食管胃颈部吻合术治疗食管癌技术上可行且安全,创伤小,手术时间短,术后恢复快,可作为治疗食管癌新的手术方式选择。Objective To explore the feasibility of single-position double-two-port(two-port thoracoscopic+two-port laparoscopic) esophagectomy and cervical anastomosis for the treatment of esophageal cancer.Methods From March 2022 to May 2022, a total of 14 cases of single-position double-two-port esophagectomy and cervical anastomosis were performed in the Department of Thoracic Surgery of Henan Cancer Hospital(8 males and 6 females, aged 45-69 years), of which 3 were in the upper thoracic segment. There were 10 cases in the middle thoracic segment and 1 case in the lower thoracic segment. All cases were pathologically diagnosed as squamous cell carcinoma before surgery. The patients were placed in the left lateral decubitus position with a 45° retrograde position, two-port thoracoscopic dissection of the thoracic esophagus and lymph node dissection, two-port laparoscopic dissection of the stomach and abdominal lymph nodes, the fabrication of tube stomach, and tube gastroesophageal right cervical anastomosis.Result All patients successfully completed single-position double-two-port esophagectomy and neck anastomosis. The average thoracic operation time was 136 minutes, the abdominal operation time was 53 minutes, the average total operation time was 228 minutes, and the intraoperative blood loss was 35-210 mL(average 70 mL), and the postoperative hospital stay was 9-15 days(average 11 days).Conclusion Single-position double-two-port esophagectomy and cervical anastomosis for the treatment of esophageal cancer is technically feasible and safe, with small trauma, short operation time, and quick postoperative recovery. It can be used as a new surgical option for the treatment of esophageal cancer.

关 键 词：单一体位 两孔胸腔镜 两孔腹腔镜 食管癌 手术方式 

分 类 号：R735[医药卫生—肿瘤]