管状吻合器在全腔镜食管癌根治术中应用的探讨

Tubular Anastomat in Radical Surgery in the Application of the Fully Endoscopic Study of Esophageal Cancer

目的：探讨管状吻合器在全腔镜Ivor Lewis食管癌根治术中的应用方法及可行性。方法：16例食管癌患者全胸腔镜下应用管状吻合器行食管胃胸内吻合术。结果：全胸腔镜下食管胃吻合术胸内吻合术16例,1例中转开胸,手术时间210~360min,其中胸部操作时间90~200min;患者术后恢复顺利,无围手术期死亡,术后无吻合口瘘、出血、呼吸衰竭、声嘶、乳糜胸等严重并发症。患者术后胸部疼痛感明显减轻。术后随访3~6个月,无死亡,无复发,长期预后进一步随访中。结论：只要掌握操作技巧,应用管状吻合器行全胸腔镜下食管胃吻合术是切实可行的,可推动食管癌手术微创化。

Objective： To explore the application method of tubular anastomat in radical resection with total endoscopic Ivor Lewis esophageal carcinoma and feasibility. Methods： 16 cases of esophageal cancer patients of video-assisted thoracoscopic application of stapler for gastroesophageal intrathoracic anastomosis. Results： The total thoracoscopic intrathoracic esophagogastric anastomosis anastomosis in 16 cases, 1 cases were converted to open chest, operation time was 210~360min, chest operation time was 90~200min; the patients recovered smoothly after operation, no peri operation period death, no serious complications of anastomotic fistula, bleeding, hoarseness, respiratory failure, such as postoperative chylothorax after. Postoperative chest pain relieve. Patients were followed up for 3~6months, no death, no recurrence, long-term prognosis of further follow-up. Conclusions： As long as the master the operating skills, application of stapler for thoracoscopic esophageal stomach anastomosis is feasible, can promote the minimally invasive operation of esophageal carcinoma.