电视胸腔镜食管癌根治性切除术20例

目的总结电视胸腔镜食管切除术的临床经验。方法2004年6月至2007年3月共有20例食管癌患者行胸腔镜食管切除术,男性15例,女性5例,平均年龄57.6岁,食管中段癌17例,食管下段癌3例。手术采用胸腔镜游离胸段食管并清扫淋巴结,开腹游离胃行食管胃颈部吻合。结果平均手术时间4.1h,其中胸腔镜游离时间1.3h,术中出血量175mL,平均清扫淋巴结15.1个,其中胸部淋巴结7.5个。平均胸管置管时间2.6d,住院时间平均8.2d。1例因单肺通气不成功中转开胸,吻合口瘘1例,心率失常2例,肺部感染1例,肺损伤1例,并发症发生率26.3%,无死亡病例。结论电视胸腔镜食管切除术在技术上是安全可行的,远期效果待随访。

Video-assisted thoracoscopic esophagectomy for esophageal squamous carcinoma

Purpose To summarize the clinical experience of video-assisted thoracoscopic esophagectomy(VATS) for treatment of esophageal squamous carcimona.Methods From June 2004 to March 2007,video-assisted thoracoscopic esophagectomy was performed in 20 patients.There were 15 men,5 women.Median age was 57.6 years(range,37-79).The tumor located at middle segment in 17 cases and lower segment in 3 cases.VATS approach was used to mobilize the intrathoracic esophageal,stomach was mobilized by open approach,esophago-gastric anastomosis was performed in the left side of the neck.Results The mean operative time was 4.1 hours,VATS operatve time was 1.3 hours,hospital stay was 8.2 days(range 6-12).One cases had to converse to open esophagectomy for unsuccess of intubate with double-lumen tube.Mean lymph node harvest was 15.1 nodes.Operative morbidity was 26.3%(anastomtic leak 1 case,atrial fibrillation 2 cases,pneumonia 1 case,acute lung injury 1 case),no perioperative mortality.Conclusions Video-assisted thoracoscopic esophagectomy is technically feasible and safe,lower morbidity and shorter hospital stay compared to open procedure.It has the potential to replace open esophagectomy in selected patients.