胸腹腔镜联合三野清扫食管癌根治术36例

目的：评价胸腹腔镜联合三野清扫食管癌根治术的手术方法、安全性、技术要点和疗效。方法收集采用胸腹腔镜联合三野清扫术治疗食管癌36例的临床资料，分析其手术时间、术后住院时间、淋巴结清扫总数、术后病理情况及手术并发症。结果本组无中转开胸病例，无手术死亡病例，平均手术时间263．3 min ，平均出血量＜50mL，平均淋巴结清扫36．5个，平均住院时间13．5d。术后并发肺部重症感染1例，声音嘶哑3例，无吻合口瘘发生，全组均顺利出院。随访2～15月，无瘤生存率100％。结论胸腹腔镜联合三野清扫食管癌根治手术可以达到与常规三切口手术相同的肿瘤切除和淋巴结清扫效果，技术上安全可行，具有创伤小、术后住院时间短、术后短期生活质量较好等方面的优点。

Video-assisted Thoracoscopic Surgery(VATS)and Laparoseope Combinedin Three-field Radicalcorrection of Esophageal Carcinoma(36 cases)

Objective To evaluate the surgical methods, security, main technical points and the curative effect of video-assisted thoracoscopic surgery(VATS)and laparoseope combined in three-field radicalcorrection of esophageal carcinoma. Methods Department completed 36 cases three-field lymphadenectomy for esophageal carcinoma by using thoracoscopic and laparoscopic minimally invasive surgery to analyse the operative time, postoperative hospital stay, total lymph node dissection, postoperative pathology and surgical complications. Results There were no conversion of thoracotomy, no operative deaths, the average operation time was 263.3 minutes, the average blood loss was under 50 mL, the average number of lymph node was 36.5, the average postoperative hospital stay was 13.5 d. Severe lung infection occurred in 1 case, voice hoarse occurred in 3 cases. There was no anastomotic fistula and the whole group were cured completely. Postoperative severe pneumonia occurred in1 cases and hoarseness occurred in 3 cases. There was no anastomotic leak and all patients were cured. The follow-up time ranged from 2 to 15 months, disease-free survival rates was 100%. Conclusion VATS and laparoseope combined in three-field radicalcorrection of esophageal carcinoma could achieve the same lymphadenectomy as the conventional three-field esophageal resection. The technique was safe and feasible, with the advantage of less trauma, shorter hospital stay, better quality of short-term postoperative life and so on.