摘要
目的 探讨胸腔镜下摘除食管平滑肌瘤的可行性.方法 回顾性分析2002年12月至2012年8月间在复旦大学附属中山医院胸外科接受胸腔镜下食管平滑肌瘤摘除术的83例患者的临床资料.全组患者肿瘤直径为 0.8～12.0（平均3.3）cm,其中肿瘤直径大于5 cm者22例.结果 3例患者术中发现食管黏膜破裂,其中2例于胸腔镜下行食管黏膜修补,另1例中转开胸修补.全组手术时间40～300（平均83.0）min,术中出血 20～150（平均52.4）ml,术后住院时间3～50（平均5.8）d.术后1例患者出现食管瘘,经胸腔引流保守治疗治愈.80例（96.4％）患者获2～117月的术后随访,随访期间所有患者吞咽困难症状均消失,未见肿瘤复发、食管憩室及食管狭窄等发生.结论 胸腔镜下摘除食管平滑肌瘤是安全、有效的手术方式,并具有创伤小、康复快等优势.对于大于5 cm的食管平滑肌瘤,胸腔镜下摘除也是可供选择的手术方式,但应在具有一定胸腔镜手术经验的中心开展.
Objective To investigate the feasibility of video-assisted thoracoscopic surgery in the treatment of esophageal leiomyoma.Methods Clinical data of 83 patients with esophageal leiomyoma from December 2002 to August 2012 treated by video-assisted thoracoscopic surgery were retrospectively analyzed.Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 82 patients.One patient was converted to thoracotomy to repair the esophageal mucosa and two patients required intraoperative mucosal repair by video-assisted thoracoscopic surgery for esophageal mucosa rupture.The mean operative time was 83.0 min （range,40-300 min）,and the mean blood loss was 52.4 ml （range,20-150 ml）.The mean length of postoperative hospital stay was 5.8 d（range,3-50 d）.The mean tumor diameter was 3.3 cm （range,0.8-12.0 cm）.One case with postoperative esophageal fistula was cured by conservative treatment.Eighty patients were followed up for 2-117 months,and all the patients were free of dysphagia without recurrencen or other related complications.Conclusions Thoracoscopic enucleation of esophageal leiomyoma can be performed effectively and safely.Thoracoscopic techniques for the removal of larger esophageal leiomyoma may be recommended as the treatment of choice in centers experienced with minimally invasive surgery.
出处
《中华胃肠外科杂志》
CAS
CSCD
2013年第9期857-859,共3页
Chinese Journal of Gastrointestinal Surgery
关键词
食管肿瘤
平滑肌瘤
外科手术
胸腔镜
Esophageal neoplasms Leiomyoma Surgical procedures Thoracoscopy
