摘要
目的 探讨腹腔镜联合胸腔镜在食管癌手术中临床效果与安全性。方法 对18例食管癌患者行电视胸腔镜联合腹腔镜下食管癌根治术,先采取左侧卧位,胸腔镜下引导下完成食管的游离和相应淋巴结的清扫,胸部操作完成后,更改为平卧位,利用腹腔镜完成腹部胃的游离,剑突下小切口完成管状胃的制作,再将管状胃从食管裂孔拉至颈部与颈段食管吻合,胃造瘘以吸除胃内容物、空肠造瘘给予肠内营养支持。结果 无中转开胸,总手术时间190~395min,平均280min;术中无大出血,总出血量100~300m L,住院期间1例患者死亡。术后有3例发生肺部感染,1例发生乳糜胸,l例于术后第4天发生颈部吻合口漏,1例出现胸腔瘘。结论 胸腔镜联合腹腔镜手术治疗食道癌在技术上是可行的、安全的,值得进一步研究和临床推广应用。
Objective To explore the clinical effect and safety of thoracoscope combined with laparoscope in treatment of esophageal cancer. Methods 18 cases of patients with esophageal cancer were treated with video assisted thoraeoscope combined with laparoscopic radical resection of esophageal cancer.First,taking the left lying position,under the guidance of the chest mirror,the esophagus and the corresponding lymph node dissection was completed.After the completion of the chest operation,changing to the supine position,laparoscopy was used to complete abdominal stomach,and small incision under xiphoid was used to complete stomach tube.Then,tubular stomach was stretched from the Kongla to the neck and neck esophageal hiatus esophagus anastomosis,gastric fistula was to absorb the contents of the stomach,enteral nutrition was supported with jejunum stoma. Results There was no conversion to open chest,total operation time was 190-395min,with an average of 280 rain.There was no major bleeding during the operation,the total amount of bleeding was 100-300mL,and one patient died during hospitalization. There were 3 cases of pulmonary infection,1 case of chylothora,1 case of cervical anastomotic leakage occurred 4 days after operation and 1 cases of thoracic fistula after the operation. Conclusion Thoracoscope combined with laparoscope in treatment of esophageal cancer is technically feasible and secure.It is worthy of further research and clinical application.
出处
《中国医药科学》
2016年第16期169-172,共4页
China Medicine And Pharmacy
关键词
胸腔镜
腹腔镜
食管癌
Thoracoscope
Laparoscope
Esophageal cancer
