单孔胸腔镜联合食管镜超微创治疗食管巨大肿物的疗效与安全性:附2例报告  

Efficacy and safety of ultramicro invasive surgery of huge esophageal masses by single aperture thoracoscope combined with esophagoscope:2 cases report

作　　者：侯铖宇 郭亚雄[1] 沈春辉[1] 吴志钰[1] 黄丽芳 杨明[1] 刘艳中[1] 瞿颖 王蓓茹 李依帆 王继勇[1] HOU Chengyu;GUO Yaxiong;SHEN Chunhui;WU Zhiyu;HUANG Lifang;YANG Ming;LIU Yanzhong;QU Ying;WANG Beiru;LI Yifan;WANG Jiyong(Department of Thoracic Surgery,The First Affiliated Hospital of the University of Chinese Medicine,Guangzhou 510405,China;The First Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;The Second Clinical Medical College,Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一附属医院胸外科,广东广州510405 [2]广州中医药大学第一临床医学院,广东广州510405 [3]广州中医药大学第二临床医学院,广东广州510405

出　　处：《分子影像学杂志》2023年第5期919-923,共5页Journal of Molecular Imaging

基　　金：广东省中医药管理局项目(20201108);广州中医药大学第一附属医院国家中医药传承创新中心科研专项重点项目(2022ZD08)。

摘　　要：目的探讨超微创外科手术在治疗食管巨大肿物上的有效性与安全性,以期为食管超微创治疗提供新思路、新方法。方法回顾性分析我院胸外科收治的2例食管巨大肿物患者,采取单孔胸腔镜配合食管镜双镜联合超微创手术的治疗方式,统计2例患者的手术时间、术中出血量、术后胸管留置时间、引流量、住院时间、病理结果及严重术后并发症发生率。结果2例患者在双镜联合超微创手术下,均成功切除食管巨大肿物。手术时间平均约230 min,术中出血量平均约20 mL。术后胸管留置时间均为3 d,引流量平均约395 mL,术后平均住院时间为7 d。均未出现术中转开胸、食管瘘、肺部感染等严重术后并发症。术后病理检查均提示食管平滑肌瘤,均治愈出院。结论单孔胸腔镜联合食管镜超微创手术为食管巨大平滑肌瘤的外科治疗,提供了新的方向和技术支持,其疗效与安全性较单一使用单孔/多孔胸腔镜或联合食管镜具有更明显的优势。Objective To explore the efficacy and safety of ultramicro invasive surgery in the treatment of huge esophageal tumors,and to provide new ideas and new methods for the treatment of esophageal ultrainvasive surgery.Methods A retrospective analysis was made on two patients with large esophageal masses who were treated by single-port thoracoscope combined with esophagoscope and double-mirror combined with ultramicroscopic surgery in our hospital.We counted the operative time,intraoperative blood loss,postoperative chest tube indwelling time,drainage volume,length of hospital stay,pathological results and the incidence of serious postoperative complications in two patients.Results The huge esophageal masses of two patients were successfully resected by double mirror combined with ultramicroscopic surgery.The average operation time was about 230 min,and the average intraoperative bleeding was about 20 mL.Postoperative retention time of chest tubes was 3 d,the average drainage volume was about 395 mL,and the average postoperative hospital stay was 7 d.There were no serious postoperative complications such as thoracotomy,esophageal fistula and pulmonary infection.Postoperative pathological examination showed esophageal leiomyoma.Both patients were cured and discharged from hospital.Conclusion Single-aperture thoracoscope combined with esophagoscope ultramicroscopic surgery provides a new direction and technical support for the surgical treatment of giant esophageal leiomyoma.Compared with single-aperture/multi-aperture thoracoscope or combined esophagoscope,its efficacy and safety have more obvious advantages.

关 键 词：单孔胸腔镜 食管镜 超微创手术 食管巨大平滑肌瘤 

分 类 号：R735.1[医药卫生—肿瘤]