全胸腔镜食管癌根治术的扶镜技巧探讨

Skills of Camera Assistant for Completely Thoracoscopic Esophageal Cancer Radical Resection

探讨全胸腔镜食管癌根治术的扶镜技巧。回顾性分析十堰市太和医院收治的200例食管癌患者临床资料,均行胸腔镜食管癌根治术,总结术中扶镜技巧,并加以探讨分析。结果200例患者中,197例患者顺利完成胸腔镜手术,平均手术时间(168.75±11.47) min,术中失血量(92.32±10.51) mL,平均住院时间(5.27±2.30) d,4例患者因吻合口漏(1例),肺部感染(2例)和伤口愈合不良(1例)延迟出院;3例患者因肿瘤与血管紧密粘连,在胸腔镜下无法成功控制出血,随即中转开胸。结论:全胸腔镜食管癌根治术是一个复杂的手术过程,扶镜质量会明显影响手术效果,扶镜手需严格掌握手术操作步骤,熟悉手术操作者的手术习惯,及时调整镜头角度和焦距,提高手术配合度,以利于手术顺利进行。

To discuss the skills of camera assistant for completely Thoracoscopic esophageal cancer radical resection. The clinical data of 200 patients with esophageal cancer admitted to our hospital from July 2017 to March 2019 were retrospectively analyzed. All patients underwent radical thoracoscopic esophageal cancer surgery, and the techniques of intraocular lens surgery were summarized and analyzed. Results of the 200 patients, 197 patients successfully completed thoracoscopic surgery, the average operation time(168.75±11.47) min, intraoperative blood loss(92.32±10.51) ml, average hospital stay(5.27±2.30) d, 4 patients Anastomotic leakage(1 case), pulmonary infection(2 cases) and poor wound healing(1 case) were delayed discharge;3 patients were unable to successfully control bleeding under thoracoscopic surgery due to tight adhesion between the tumor and blood vessels, and then transferred to open the chest;Conclusions thoracoscopic esophageal cancer radical resection is a complicated surgical procedure. The quality of the mirror will significantly affect the surgical results. The mirror surgeon needs to strictly master the surgical procedures, familiarize with the surgical procedures of the operator, and adjust the lens angle and focal length in time to improve. The degree of surgical cooperation is conducive to the smooth operation of the operation.