全腔镜手术在食管癌根治术中的应用及其疗效分析

THE THERAPEUTIC EFFECTS OF THORACOSCOPIC AND LAPAROSCOPIC ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

目的探讨胸、腹腔镜联合手术治疗食管癌的近期和中期临床疗效。方法回顾性分析2012年3月—2013年8月,实施了全腔镜下食管癌根治术的40例食管癌患者的临床资料及手术中远期疗效。结果全组手术无中转开胸及死亡病例,手术时间(246±51.2)min,术中出血量(170.0±92.5)ml,平均清扫淋巴结(23.8±9.4)枚/例,术后肺部感染发生率12.5%(5/40)、吻合口瘘发生率2.5%(1/40)。结论腔镜食管癌手术的创伤及并发症低于开胸手术,安全可行,疗效确切。

Objective To compare the shol：t term and medium term therapeutic effects of combined thoraco- scopic and laparoscopic esophagectomy for esophageal cancer. Methods From March 2012 to August 2013, 40 patients with esophageal cancer were taken combined thoracoscopic and laparoscopic esophagectomy. There were 32 men and 8 women with median age of 58.7 years old. The tumor located at middle segment in 20 cases, upper segment in 19 cases and lower segment in 1 case. Video- assisted thoracoscopic esoph- agectomy （VATS） approach was used to mobilize the intrathoracic esophageal, laparoscopic esophagectomy was used to mobilize the stomach and esophago - gastric anastomosis. Results During the hospitalization, no patient died. The operative time was （246 ± 51.2） min. The amount of bleeding during operation was （170.0 ± 92.5）ml. The mean lymph node harvest was （23.8 ± 9.4） nodes. The incidence of postoperative pulmonary infection was 12.5 % （5/40）, anastomotic leak was 2.5 % （ 1/40 ）. Conclusion Combined thora- coscopic and laparoscopic esophagectomy has some advantages in patients with esophageal cance and its me- dium term outcome benefits is similar with open esophagectomy.