胸腔镜辅助食管癌切除术(附38例报告)

Video-assisted thoracoscopic esophagectomy for esophagus cancer :a report of 38 cases.

目的 探讨电视辅助胸腔镜手术 (VATS)在治疗食管癌中的应用、手术方法及临床效果。方法 利用胸腔镜技术对 38例食管癌病人进行手术 ,并对手术操作、并发症及术后恢复等情况进行总结性分析。结果 38例病人全部采用VATS方法完成手术 ,1例发生支气管胸膜瘘 ,5例术后发生吻合口瘘 ,经简单对症治疗全部治愈 ,无死亡病例。术后 1年、3年、5年生存者 ,分别为 10、8、4例 ,术后因肿瘤转移死亡 3例 ,其它原因死亡 2例 ,失访 7例 ,余 4例为术后不足 1年的病人 ,尚未见肿瘤复发、转移情况。结论 只要掌握好胸腔镜的操作技巧及食管癌切除的手术指征 ,VATS治疗食管癌不但是可行的 。

Objective\ To evaluate the clinical application and effect of video-assisted thoracoscopic surgery(VATS)in treatment of esophagus cancer.Methods\ Under VATS,esophagectomy was performed on thirty-eight patients with esophagus cancer.The operating style,complications and recovery after operation were studied.Results\ There was no case died of VATS operation in 38 cases.Five patients,who had anastomotic leakage after operation,recovered completely after simple treatment.Followed up 1,3 and 5 years,the survivals were 10,8 and 4 cases respectively.Three patients died of tumor metastasis and two died of other causes.Seven cases were out of follow-up.Other 4 cases,who received operation less than one year,showed no any of tumor recurrence.Conclusion\ VATS plays an important role in esophagectomy for cancer of the esophagus when there are proper indications and good techniques under thoracoscopy.