腹腔镜食管下段平滑肌瘤切除体会5例报告

Laparoscopic excision of leiomyoma at the distal esophagus:with a report of 5 cases

目的探讨腹腔镜食管下段平滑肌瘤切除术的可行性及安全性。方法对5例食管下段平滑肌瘤行腹腔镜下食管游离,肌层切开剥除肿瘤。结果全腹腔镜下完成手术,无中转开腹,肿瘤切缘阴性。手术时间84～147 min,平均109 min。术中出血量20～50 mL。术后2～3 d排气进食,术后7～10 d出院。未发生出血、食管瘘等术后并发症。平均随访10个月无复发。结论腹腔镜食管下段平滑肌瘤切除术创伤小、恢复快、安全可行。

ObjectiveWe aimed to explore the feasibility and safety of laparoscopic approach in the treatment of leiomyoma at the distal esophagus.MethodsBetween July 2008 and July 2010,esophageal leiomyomas were resected in 5 patients by laparoscopic enucleation procedure.ResultsAll patients underwent laparoscopic enucleation without conversion to open surgery.The tumor was removed completely with negative cutting edges.The mean operation time was 109 minutes（range,84-147 min）,no massive hemorrhage occurred,the intraoperative blood loss ranged from 20 to 50 ml.Postoperative oral feedings were resumed after 2-3 days of surgery.The mean postoperative hospital stay was 8.3 days（range 7-10days）.No postoperative complications including hemorrhage and leakage occurred.At a mean follow-up period of 10 months（range,3-14months）,no evidence of recurrences was observed in endoscopy or radiology.ConclusionLaparoscopic enucleation is a minimally invasive procedure which is both feasible and safe for the treatment of leiomyoma at the distal esophageal.