纤维胃镜辅助胸腔镜下食管平滑肌瘤及间质瘤切除术

Treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoracoscope under the assistance of fiber gastroscope

目的总结纤维胃镜辅助胸腔镜下食管平滑肌瘤、间质瘤切除术的临床经验。方法回顾性分析2004年10月至2009年12月收治的14例食管平滑肌瘤和2例食管间质瘤患者的临床资料，均采用纤维胃镜辅助胸腔镜下肿瘤黏膜外切除术。根据病变部位选择不同的手术路径及操作孔位置，术中在纤维胃镜辅助下准确定位，在切除肿瘤后检测食管黏膜有无破损。结果16例患者无围手术期死亡及严重并发症发生。术后均经病理检查确诊。13例随访6～48（18．5±9．5）个月，进食通畅，无肿瘤复发。结论纤维胃镜辅助胸腔镜下食管平滑肌瘤、间质瘤切除术具有术中定位准确、微创、彻底、并发症少等优点，是食管良性肿瘤首选的治疗方法。

Objective To summarize the experience on treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoraeoscope under the assistance of a fiber gastroscope. Methods The clinical data of 14 cases of esophageal leiomyoma and 2 eases of esophageal mesenchymoma treated with video-assisted thoracoscope under the assistance of fiber gastroscope from October ：2004 to December 2009 was retrospectively analyzed. Selected different surgical path and operation hole position according to the lesion site. Fiber gastroscope was conductive to accurately find lesion positions,and detected esophageal mucosa was breaked or not. Extra-mucosal excision was conducted in 16 cases. Results There was no death and severe complications during perioperative period, Patients were diagnosed by pathological examination. Thirteen cases were followed up for 6-48 （18.5 ± 9.5 ） months,all patients ate unobstructed, and without relapse. Conclusion Treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoracoscope under the assistance of fiber gastroscope has the advantages of intraoperative accurate positioning, minimally invasive,thoroughly,fewer complications,and it is the first choice of esophageal benign tumor treatment.