电视胸腔镜辅助小切口食管癌切除食管、胃胸内吻合术

目的探讨胸腔镜辅助小切口行食管癌切除食管、胃胸内吻合的可行性,并介绍手术具体操作方法。方法2002-08～2003-05采用胸腔镜辅助小切口施行食管癌切除食管胃胸内吻合12例,其中中段癌2例、下段癌8例、贲门癌2例;肿瘤长度2～5cm。结果手术时间平均为110min,术中失血量平均为110ml,术后引流量平均130ml。术后48～72h拔除胸腔引流管,拔管后即能自行下床活动,切口疼痛轻微。术后无严重并发症发生。平均住院11d。结论胸腔镜辅助小切口行食管癌切除食管、胃胸内吻合是可行的,但应严格掌握适应证和手术操作技术。

Resection of esophageal carcinoma and intrathoracic gastro-esophageal anastomosis via VATS associated with minithoracotomy

Objective To study the adaption of the resection of esophageal carcinoma and the intrathoracic gastroesophageal anastomosis via VATS associated with minithoracotomy,and,to recommend the operation procedure.Methods The10cases of esophageal carcinoma (2in middle segment,8in lower segment)and2cases of cardiac carcinoma were treated by above method,i.e first,freeing stomach by median incision in the upper belly,then resection of esophageal carcinoma and the intrathoracic anastomosis were completed by video thoracoscope(VATS)associated with minimal incision(5-8cm)in the5th rib interspace.Results The average-time of operation was110min.The average bleeding volume was110ml.The postoperative pain of incision was minimal.The drainage tube of thorax was pulled out within48-72h and all the patients had a satisfied out-of-bed activity after extubation.No complications happened in this group.The average hospitalization time was11days.Conclusion The recommend method is proper for the the treatment of esophageal carcinoma in middle especially in lower segment and caidiac carcinoma.But the adaption of the operation indication must be controlled strictly and the operation procedure is the most important.