食管良性疾病的胸腔镜手术

目的：探讨食管良性疾病的胸腔镜治疗技术在我国的实用性和安全性。方法：在4个胸腔镜套管切口下分别为29例食管良性疾病病人施行手术治疗，其中食管平滑肌瘤摘除术15例，贲门失弛缓症肌层切开术6例，食管结核病灶清除术，食管憩室切除术和食管裂孔疝 修补术各2例，食管囊肿切除和取异物术各1例，结果：无手术死亡及严重手术并发症，有3例病人中转开胸手术，其中2例因食管粘膜撕裂，1例因胸膜致密粘连，平均手术时间为95min，术后平均住院日为6d。结论：食管良性疾病的胸腔镜手术创伤小，恢复快，手术瘢痕小，这种安全，效果可靠的新术式应取代常规开胸手术。

Video-assisted thoracoscopic surgery for benign esophageal diseases

Objective: This paper reported our experience with thoracoscopic management of benign esophageal diseases to define the efficacy and safety of this approach in China. Methods: Twenty nine patients (13 men and 16 wonmen) with benign esophageal diseases underwent thoracoscopic surgery. All procedures were finished under 4 port incisions.Esophageal leiomyoma were removed by videothoracoscopic enucleation in 19 patients. Thoracoscopic esophagomyotomy was done in 6 patients with achalasia. Other procedures included esophageal tuberculosis debridement in 2, esophageal diverticula resection in 2, hiatal hernia repair in 2, esophageal cyst resection in 1 and removal of esophageal foreign body in 1. Results: There was no operative death or major perioperative complications. Three cases were converted to limited thoracotomy because of mucosa leakage in 2 and dense pleural adhesion in 1. Mean operation time was 95 minutes and hospital stay averaged 6 days. Conclusion: Patients with benign esophageal diseases can benefited by video assisted thoracoscopic approach with decreased operative trauma, quick recovery, and minimal scar. This new approaches is safe and effective, and should be a reasonable alternative to open operation.