胸、腹腔镜联合治疗食管癌2例报告

目的探讨胸、腹腔镜联合治疗食管癌的可行性和近期疗效。方法全麻。胸腔镜经4个trocar游离胸段食管并打开膈肌，留置引流管。腹腔镜同样经4个trocar游离胃。腹腔操作结束后，将食管从颈部切口提出，直视下切除病灶并吻合。留置鼻胃管和鼻空肠管。结果手术时间450、470min；术中出血量150、200ml，病灶彻底清除，切缘阴性。术后病理2例均为高分化鳞癌，T1N0M0。2例均随访4个月，无复发。结论胸、腹腔镜联合食管切除术可行，近期疗效满意。

Combined use of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma: A report of 2 cases

Objective To explore the feasibility and short-term efficacy of combined use of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma. Methods The study included 2 patients.The operation was conducted under general anesthesia.The esophagus was disconnected and the diaphragm was opened under a 4-port thoracoscopy.Then the stomach was dissociated under a 4-port laparoscopy.The esophagus was mobilized outside the thorax through a!cervical incision after the imple mentation of laparoscopic performance.Under direct vision,the lesion was removed and an anastomosis was made.A naso-intestinal tube and a naso-gastric tube were placed,respectively.Results The operation time was 450 and 470 min,and the intraoperative blood loss was 150 and 200 ml,respectively.The lesion was thoroughly removed with negative cutting edges.Postoperative pathological reports showed well-differentiated squamous cell carcinoma(stage T_1N_0M_0) in both of patients.Follow-up for 4 months in two cases found no recurrence.Conclusions Combined use of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma ensures the feasibility and safety of esophagectomy,with minimal invasion and low postoperative complication incidence.