单孔充气式纵隔腔镜联合腹腔镜食管癌根治术治疗局部晚期食管癌效果分析  

Analysis of therapeutic effect of single-port inflatable mediastinoscopy combined with laparoscopy in locally advanced esophageal cancer

作　　者：李小兵[1] 乔孟晗 吴俊鹏 付东宏[1] 刘季钊 田志强 冯绍康 Li Xiaobing;Qiao Menghan;Wu Junpeng;Fu Donghong;Liu Jizhao;Tian Zhiqiang;Feng Shaokang(Department of Thoracic Surgery,Anyang Cancer Hospital,Anyang,Henan 455000,China)

机构地区：[1]河南安阳市肿瘤医院胸外科,安阳455000

出　　处：《河南外科学杂志》2024年第6期16-18,共3页Henan Journal of Surgery

基　　金：河南省医学科技攻关计划联合共建项目:项目编号LHGJ20210880。

摘　　要：目的探讨单孔充气式纵隔腔镜联合腹腔镜食管癌根治术治疗局部晚期食管癌的效果。方法回顾性分析2022-03—2024-04安阳市肿瘤医院胸外科行单孔充气式纵隔腔镜联合腹腔镜食管癌根治术的38例局部晚期食管癌患者的临床资料,女7例,男31例,年龄(64.34±5.65)岁。胸上段2例,胸中段33例,胸下段3例。采用新辅助治疗的29例患者中,同步放化疗5例、靶向治疗联合化疗6例、免疫联合化疗18例。结果38例患者均顺利完成手术,顺利出院。术后病理均R0切除。手术时长(256.36±45.65)min,术中出血量(60.47±60.34)mL,清扫淋巴结(22.86±8.34)个,住院时间(10.32±3.15)d。术后1例因刺激性咳嗽再次入院,对症治疗3 d出院。1例术后第4天出现吻合口漏,给予对症治疗后痊愈出院。1例术后右侧气胸,未予处理,自行吸收。2例术后出现食管裂孔疝,进行食管裂孔疝修补术。6例术后声音嘶哑,经对症处理恢复正常。本组未出现乳糜胸患者。结论单孔充气式纵隔腔镜联合腹腔镜食管癌根治术治疗局部晚期食管癌患者是安全、可行的。Objective To explore the efficacy of single-port inflatable mediastinoscopy combined with laparoscopic esophageal cancer radical surgery in locally advanced esophageal cancer.Methods A retrospective analysis of clinical data from 38 patients with pathologically staged pT 1-3 N 1-3 M 0,ypT 1-3 N 1-3 M 0 esophageal cancer treated at the thoracic surgery department of Anyang Cancer Hospital from March 2022 to April 2024 was performed.The cohort included 7 females and 31 males with a mean age of(64.34±5.65)years.Esophageal segments involved were:2 upper,33 middle,and 3 lower.Nine patients did not receive neoadjuvant therapy,while 29 patients underwent neoadjuvant therapy,including 5 with synchronous chemoradiotherapy,6 with targeted therapy combined with chemotherapy,and 18 with immunotherapy combined with chemotherapy.All patients underwent single-port inflatable mediastinoscopy combined with laparoscopic esophageal cancer radical surgery.Results All 38 patients successfully completed the surgery without conversion to transthoracic procedures or perioperative mortality.All patients were discharged uneventfully.Postoperative pathology confirmed R0 resection in all cases.Mean operative time was(256.36±45.65)minutes,mean intraoperative blood loss was(60.47±60.34)mL,and mean lymph node harvest was(22.86±8.34).Mean hospital stay was(10.32±3.15)days.One patient was readmitted for a persistent cough and discharged after 3 days of treatment.One patient experienced anastomotic leakage on postoperative day 4,which resolved with conservative management.One patient presented with a right-sided pneumothorax that resolved spontaneously.Two patients developed esophageal hiatal hernias requiring secondary repair.Six patients experienced postoperative hoarseness.No cases of chylothorax were observed.Conclusion Single-port inflatable mediastinoscopy combined with laparoscopic esophageal cancer surgery appears safe and feasible for locally advanced esophageal cancer.

关 键 词：单孔充气式纵隔镜 腹腔镜 局部晚期食管癌 快速康复外科 

分 类 号：R735.1[医药卫生—肿瘤]