经单一切口腹腔镜手术系统（SILS-Port系统）胸、腹腔镜联合在食管癌根治术中的应用

目的探讨经单一切E1腹腔镜手术系统（SILS—Port系统）胸、腹腔镜联合在食管癌根治术中的应用。方法2011年8月～2013年5月我科经SILS—Port系统施行胸、腹镜联合食管癌根治术5例。肩胛听诊三角区第6肋间为观察孔，胸腔镜下两操作孔游离胸段食管及清扫淋巴结，通过SILS系统，腹腔镜下两孔游离胃及清扫淋巴结，胃上提至颈部与食管吻合。结果手术过程顺利，围手术期无死亡。腔镜手术时间（296．0±24．1）min，术中出血量（114±40）ml，术后胸、腹腔引流时间均是（1．2±0．4）d。术后第3天疼痛评分（2．2±0．8）分。5例分别清扫淋巴结9、8、6、5、7枚，其中2枚阳性。5例分别随访10、22、8、16、3个月，1例术后16个月肿瘤复发转移，无死亡。结论经SILS-Port系统胸、腹腔镜联合根治性切除早期、无明显外侵的中下段食管癌，创伤小，出血少，安全可靠。

Application of SILS-Port System in Thoracoscopic and Laparoscopic Radical Surgery for Esophageal Carcinoma

Objective To investigate the application of SILS-Port system in thoracoscopic and laparoscopic radical surgery for esophageal carcinoma. Methods Five cases of esophageal cancer underwent thoracoscopic and laparoscopic radical surgery with SILS-Port System in our hospital from August 2011 to May 2013. The observation hole was located in the 6th intercostal space on the scapula triangle. We separated esophageal thoracic segments and dissected intrathoracic lymph nodes via the two operating holes. Through SILS port system under laparoscopy, we freed the stomach and cleaned the abdominal lymph nodes via two holes, and then performed esophagus-stomach anastomosis. Results All the operations were performed successfully without perioperative death. The operative time was （296.0 ± 24. 1 ） min, intraoperative blood loss was （ 114 ± 40） ml, postoperative chest and abdominal drainage time was （ 1.2 ± 0.4） d, and pain scores on the third postoperative day were （2.2 ± 0.8 ） points. The number of dissected lymph nodes was 9, 8, 6, 5, 7, respectively,and 2 lymph nodes were positive. Five patients were followed up for 10, 22, 8, 16, 3 months, respectively. During the period, there was one case of tumor metastasis and no death occurred. Conclusion SILS-port system in thoracoscopic and laparoscopic esophagectomy is a safe and effective procedure for the treatment of middle and low segment esophageal cancer of early stage.