电视胸腔镜联合腹腔镜食管癌根治性切除术15例

Combining thoracoscopy and laparscopy for treatment of esophageal carcinoma in 15 patients

目的探讨电视胸腔镜联合腹腔镜食管癌根治性切除术的可行性和近期疗效。方法 2009年12月至2010年6月15例食管癌患者施行了联合腔镜食管癌切除。食管癌位于上段者2例,中段11例,下段者2例。术后病理分期:T1N0M04例、T2N0M02例、T2N1M03例、T3N0M04例、T3N1M02例。手术先用胸腔镜游离胸段食管并清扫淋巴结,再用腹腔镜游离胃行食管胃左颈部吻合。结果除1例患者因气管膜部损伤开胸修补外,全组患者无中转手术及死亡,术后出现吻合口瘘和乳糜胸各1例,均保守治疗后痊愈,2例声音嘶哑。随访1～6个月,患者全部生存,无复发。结论胸、腹腔镜联合行食管癌根治术在技术上是安全可行的,近期疗效满意。

Objective To explore the feasibility and term efficacy of using laparscope and video-assisted thoracoscopic surgery（VATS）in radical correction of esophageal carcinoma.Methods Combining thoracoscopic and laparscopic esophagectomy was attempted in 15 patients with esophageal carcinoma between December 2009 and June 2010.The tumor located at upper segment in 2 cases,at middle segment in 11 cases and lower segment in 2 cases.Pathological staging：T1N0M0 in 4 patients,T2N0M0 in 2 patients,T2N1M0 in3 patients,T3N0M0 in 4 patients,T3N1M0 in 2 cases.VATS approach was used to mobilize the intrathoracic esophageal and lymph node dissection,stomach was mobilized by laparoscopic approach,esophago-gastric anastomosis was peformed in the left of the neck.Results Except for 1 patient injury due to thoracic membranous trachea repair,the whole group of patients was not conversed to open operation and no patient died.Postoperative complications included anastomotic leak（1 case,recovered after conservative treatment.）chylothorax（1 case,cured by conservative treatment.）,and hoarseness（2 cases）.Follow-up 1-6 months,all patients survive without recurrence.Conclusion Combining thoracoscopic and laparscopic esophagectomy is technically feasible and safe,the recent results is satisfactory.