手辅助电视胸腔镜食管癌切除胃食管胸内吻合术(附15例报告)

目的 总结手辅助电视胸腔镜 (HVATS)食管癌切除胃食管胸内吻合术。方法 2 0 0 3～ 2 0 0 4年施行HVATS食管癌切除胃食管胸内吻合术 15例。其中T3 N1M0 期 11例 ,T2 N1M0 期 2例 ,T2 N0 M0 期 2例 ;均在右胸内吻合 ,其中胸顶吻合 10例 ,弓下吻合 5例。结果 手术和术后康复均顺利 ,没有并发症 ,无围术期死亡。胸部手术时间平均 (4 2 2 8± 7 13)分钟 ,胸部失血 (87 4 3± 17 5 9)ml,术后第 1天引流量 (2 12 0 4± 4 3 79)ml;清扫食管旁淋巴结 (3 74± 1 17)枚 ,清扫纵隔淋巴结 (5 98± 3 4 3)枚。结论 HVATS食管癌切除胃食管胸内吻合术能够达到常规开胸手术相同的切除效果 ,且具有手术时间短、创伤小、恢复快等优点。

Objective To summarize the experiences of resection of esophagus carcinoma and interthoracic gastroesophagostomy by hando-video-assisted surgery(HVATS).Methods 15 patients were performed by HVATS for resection of esophagus carcinoma and interthoracic gastroesophagostomy .TNM stage of 11 cases were T_3N_1M_0,2 cases were T_2N_1M_0,2 cases were T_2N_0M_0;all cases were performed right thoracic anastomosis.The upper mediastinal anastomosis were performed in 11 cases,under the arch of azyos vein anastomosis in 5 cases.Results No complication and perioperation mortality was observed.All cases recoveried very well .The mean thoracic operating time was (42.28±7.13)minutes.The mean thoracic operating blood loss was (87.43±17.59)ml and the chest tube drainage of the first day after opertion was(212.04±43.79)ml.The number of lymph nodes dissection was 3.74±1.17 in group of periesophageal nodes and 5.98±3.43 in group of mediastinal nodes .Conclusions Resection of carcinoma of the esophagus and interthoracic gastroesophagostomy by HVATS have the same resection result compared with the routine open thoracotomy;it has the virtue of less trauma,soon recovery,short operating time,less pain,low blood loss and et al.