胸、腹腔镜联合Ivor Lewis食管癌根治术

Laparoscopic and Thoracoscopic Ivor Lewis Esophagectomy

目的探讨胸、腹腔镜联合行Ivor Lewis食管癌根治术的可行性和近期疗效。方法2007年12月,胸腹腔镜联合行Ivor Lewis食管癌根治术1例,腹腔镜经5个trocar游离胃,并制作管状胃。胸腔镜经4个trocar游离胸段食管,切除病灶并打开膈肌,将管状胃提至胸顶使用吻合器吻合。所有手术操作均在镜下完成。结果手术时间330min,术中出血量200ml,病灶彻底切除,切缘阴性。术后病理为高分化鳞癌,T2N0M0。随访3个月,无复发。结论胸、腹腔镜联合行Ivor Lewis食管癌根治术可行,近期疗效满意。

Objective To explore the feasibility and short-term efficacy of combined use of laparoscopic and thoracoscopic Ivor Lewis esophagectomy for the treatment of esophageal carcinoma. Methods A case of esophageal carcinoma was treated in our hospital in December 2007. Five trocars were used via laparoscopy to free the stomach and create a tube-like stomach. Afterwards, thoracoscopy was carried out via 4 trocars to remove the lesion and open the diaphragm, and then the tube-like stomach was pulled into the chest cavity and anastomosed to the chest wall. -Results The operation time was 330 min, and the intraoperative blood loss was 200 ml. The lesion was removed completely with negative cutting edges. Postoperative pathological examination showed squamous cell carcinoma （ stage T2N0M0 ）. Follow-up was available for 3 months, during which no recurrence was found. Conclusion Laparoscopic and thoracoscopic Ivor Lewis esophagectomy is feasible and safe for the treatment of esophageal carcinoma.