腔镜食管癌根治术在食管癌治疗中的临床应用

目的探讨腔镜食管癌根治术的安全性及可行性。方法回顾性分析2008年6月至2012年4月福建省肿瘤医院298例行腔镜辅助食管癌根治术患者的临床资料。结果297例在腔镜辅助下成功完成手术，1例中转开腹。手术用时（242．3±58．7）min，术后住院时间（17．4±9．8）d。淋巴结清扫总数（27．5±12．2）枚／例，其中纵隔、腹腔及颈部淋巴结清扫数目分别为（10．7±5．7）、（13．3±7．8）及（7．7±8．1）枚／例。89例（29．9％）出现手术相关并发症，其中肺部感染41例，术后声嘶25例，吻合口瘘9例，切口感染7例，其他7例。术后经2～47个月的随访，3例患者出现吻合口狭窄，其余进食及生活质量良好。结论腔镜辅助胸食管癌根治术是安全、微创、有效的手术方法。

Clinical application of minimally invasive esophagectomy for esophageal carcinoma

Objective To investigate the feasibility and safety of minimally invasive esophagectomy （MIE） for esophageal carcinoma. Methods Clinical data of 298 esophageal carcinoma cases who were treated by MIE in the Fujian Provincial Cancer Hospital from June 2008 to April 2012 were retrospectively reviewed. Results A]] the patients underwent MIE successfully except one conversion to open surgery. The mean operative time was（242.3±58.7） rain. The postoperative length of hospital stay was （17.4±9.8） d. The number of harvested lymph nodes of total, the mediastinum, the abdomen and the cervix was 27.5±12.2, 10.7±5.7, 13.3±7.8, and 7.7±8.1, respectively. Postoperative complication rate was 29.9%, including pneumonia （n=41）, recurrent laryngeal nerve injury （n=25）, anastomotic leak （n=9）, wound infection （n=7）, and others （n=7）. After follow up of 2 to 47 months, 3 patients were found to develop anastomotic stricture. There were no recurrence, metastasis, or death. Conclusion Minimally invasive esophagectomy is a safe, feasible, effective and minimally invasive surgical technique.