摘要
目的探讨胸腔镜下食管癌切除术的适应证。方法2005年1月～11月，我院行胸腔镜下食管癌切除术11例。其中胸上段食管癌2例，胸中段8例，胸下段1例。T1N0M01例，T2N0M02例，T2N1M01例，T3N0M07例。胸腔镜下经右胸游离胸段食管及肿瘤，清扫胸腔内淋巴结，上腹部正中切口完成胃的游离及清扫腹腔内淋巴结，颈部切口完成食管癌切除胃食管颈部吻合术。结果1例因双腔气管插管失败，1例因胸腔粘连中转开胸，另9例经胸腔镜手术成功。手术时间220～300min，平均265min。术中出血量150～400ml，平均240ml。清扫淋巴结4～10枚，平均6．4枚。术后2～3d拔除胸腔引流管，引流量200～500ml，平均350ml。术后喉返神经损伤1例，术后3个月恢复。11例随访4～15个月，平均8个月，均健在，无肿瘤复发和转移。结论胸腔镜下食管癌切除术主要适用于食管癌临床Ⅰ期及Ⅱ期，肿瘤长度〈5cm，无外侵及纵隔明显肿大淋巴结的患者。
Objective To investigate indications of video-assisted thoracoscopic surgery in the treatment of esophageal carcinoma. Methods Video-assisted thoracoscopic surgery was performed in 11 patients with esophageal carcinorma from January 2005 to November 2005. The tumors were located at the upper segment in 2 patients, middle segment in 8 patients, and lower segment in 1 patient. The TNM staging results showed T1N0M0 in 1 patient, T2N0M0 in 2 patients, T2N1M0 in 1 patient, and T3N0M0 in 7 patients. Under thoracoscopy via thoracic and cervical incisions, the esophagus and tumor were disconnected and the intrathoracic lymph nodes were cleared through the right thorax. Then a median incision was made at the epigastrium. Through the incision the stomach was disconnected and intraabdominal lymph nodes were removed. Afterwards, esophagectomy and gastroesophagostomy were performed by way of the cervical incision. Results The operation time was 220 - 300 min （ mean, 265 min）. The operative blood loss was 150 - 400 ml （ mean, 23,0 ml）. The number of removed lymph nodes was 4 - 10 （ mean, 6.4）. The drainage tube was taken out at 2 - 3 days after operation, with a drainage volume of 200 - 500 ml （ mean, 350 ml）. One patient developed a temporary left recurrent laryngeal nerve palsy that disappeared at 3 months after operation. Follow-up checkups for 4 - 15 months （mean, 8 months） in the 11 patients showed no recurrence or metastasis of tumor. Conclusions Video-assisted thoracoscopic surgery can be adopted in patients with esophageal carcinoma at stage Ⅰor Ⅱ , 〈 5 cm in diameter, and without outward infiltration and enlarged mediastinal lympy nodes.
出处
《中国微创外科杂志》
CSCD
2006年第8期571-572,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
食管癌
电视胸腔镜手术
Esophageal carcinoma
Video-assisted thoracoscopic surgery
