充气纵隔镜联合腹腔镜食管癌切除术的临床进展

Clinical progress of inflatable video‐assisted mediastinoscopic transhiatal esophagectomy

手术是治疗可切除食管癌的重要手段。随着食管微创技术的不断发展,胸腔镜食管癌切除术较传统开胸手术体现出明显优势,已经被广泛接受。但仍然有部分食管癌患者无法从中获益。充气纵隔镜联合腹腔镜食管癌切除术因其无需单肺通气,减少术后并发症并且扩大了手术指征,为肺功能受损以及胸腔病变患者带来手术机会,成为食管癌治疗新选择。但是有限的手术视野和隧道式手术方式增加了手术难度,如何清晰显露解剖结构以及彻底清扫淋巴结一直是该手术的重点与难点。笔者查阅相关文献,对充气纵隔镜联合腹腔镜食管癌切除术的临床进展及存在的局限性进行阐述。

Surgery is an important method for the treatment of resectable esophageal cancer.With the continuous development of minimally invasive esophageal technology,video-assisted thoracoscopic esophagectomy(VATE)has demonstrated obvious advantages over conventional open surgery and has been widely accepted.However,there are still some esophageal cancer patients who cannot benefit from VATE.Inflatable video‐assisted mediastinoscopic transhiatal esophagectomy(IVMTE)does not require one‐lung ventilation,reduces postoperative complications,expands surgical indications,and brings surgical opportunities for patients with impaired lung function and thoracic lesions,which has become a new choice for the treatment of esophageal cancer.However,the limited field of surgical view and the tunneling surgical approach undoubtedly increase the difficulty of surgery,and how to clearly expose the anatomical structures and thoroughly dissect the lymph nodes has always been the key points and difficulties of surgery.The authors review relevant literatures to discuss the clinical progress and limitations of IVMTE.