纵隔镜联合腹腔镜手术治疗早期及浅表食管癌的效果分析

目的 探讨纵隔镜联合腹腔镜手术治疗早期及浅表食管癌的效果和安全性。方法 回顾性分析2014年6月至2016年6月收治的21例早期及浅表食管癌患者的临床资料。上述患者均接受纵隔镜联合腹腔镜手术，离断颈部食管、纵隔镜下应用推进器食管内翻下推分离食管，腹腔镜游离胃，经膈裂孔分离食管与纵隔镜会师，推进器上提食管及胃至颈部，完成食管胃底吻合。结果 全组均顺利完成手术。术后并发吻合口漏1例、快速心房纤颤4例、呼吸道感染1例和声音嘶哑1例。无围术期死亡病例。结论 纵隔镜联合腹腔镜下推进器食管内翻分离微创手术治疗早期及浅表食管癌，安全有效、康复快。

Effect of mediastinoscopic and laparoscopic esophagectomy for early stage and superficial esophageal cancer

Objective To evaluate the effect and safety of mediastinoscopic and laparoscopic esophagectomy for early stage and superficial esophageal cancer.Methods A total of 21 patients diagnosed with early stage or superficial esophageal cancer from June 2014 to June 2016 were enrolled in this study.Laparoscopy was preceded by breaking the cervical esophagus from the left neck, and the mucosal surface of the cervical esophageal stump was turned inward and affixed to a pushstick.Then, we pushed down and separated the upper thoracic esophagus with mediastinoscopy, as well as mobilized stomach and separated the lower thoracic esophagus with laparoscopy from the diaphragmatic hiatus till the whole esophageal mobilization was completed.Then, we lifted the esophagus and stomach to the neck by pushstick and constructed the esophagogastroanastomosis.Results All patients were recovered and obtained successful results without perioperative death.Postoperative complications included anastomotic leakage in one case, rapid atrial fibrillation in four cases, respiratory infection in one case and hoarseness in one case.Conclusion Mediastinoscopic combined with laparoscopic esophagectomy can be performed safely, effectively for patients with early stage and superficial esophageal cancer.