电视纵隔镜手术治疗早期食管癌89例报告

Experience of Video-mediastinoscopy in the Treatment of Early Esophageal Cancer:Report of 89 Cases

目的探讨电视纵隔镜在食管癌切除手术中的应用。方法2005年10月～2009年2月,对89例早期食管癌行常规电视纵隔镜下食管癌切除术。术中使用电视纵隔镜游离食管,经腹部切口游离胃,切除食管后,将食管残端与胃底做颈部吻合。结果1例术中发生出血,中转开胸;余88例顺利完成手术。无围手术期死亡病例。86例随访1～38个月,其中<6个月16例,7～12个月9例,13～18个月21例,>24个月40例,中位随访时间为17个月。死亡8例,生存时间8～29个月(平均17.8月),其中5例因肿瘤复发死亡,3例死亡原因不明。结论电视纵隔镜下食管癌切除术是一种安全、有效的术式,尤其适用于心、肺功能较差的早期食管癌患者。

Objective To investigate the value of video-mediastinal endoscopy in the resection of esophageal cancer at the early stage.Methods From October 2005 to February 2009,89 patients with esophageal cancer underwent video-mediastinal endoscopic resection of esophageal cancer in our hospital.We isolated the esophageal by video-mediastinoscopy and then the stomach through an abdominal incision,afterwards the esophageal and gastric stump was anastomosed through the neck incision.ResultsExcept for one case who was converted to open surgery because of massive hemorrhage,video-mediastinal endoscopy was completed in all the patients.No patient died during perioperative period.Follow-up was achieved in 86 cases for 1 to 38 months（〈6 months in 16 cases,7-12 months in 9 cases,13-18 months in 21 cases,and 24 months in 40 cases）with a median of 17 months.During the period,8 cases died,the mean survival time of this series was 17.8 months（8-29 months）.Of the 8 death,5 died of recurrent tumor,and the other 3 died of unknown reasons.Conclusions Video-mediastinal endoscopic resection is safe and effective for esophageal cancer especially for patients with early stage esophageal cancer complicated with cardiovascular or pulmonary diseases.