电视胸腔镜辅助下食管癌切除（附33例报告）

目的：总结电视胸腔镜辅助下（video-assisted thoraeoscopic surgery,VATS）食管癌切除的临床经验,评价VATS食管癌切除的近期效果.方法：回顾性分析我院1998年1月至2009年12月行VATS食管癌切除的33例临床资料.男21例,女12例;年龄37-83岁,平均65岁.肿瘤平均长度4.8cm,均为鳞状细胞癌.胸上段癌7例,胸中段癌13例,胸下段癌13例;TNM分期：T1 N0M0 5例,T1N1M0 8例,T2N0M0 10例,T2N1M0 8例,T3N1M02例.手术操作分三步：经右胸VATS游离食管肿瘤清扫淋巴结;经上腹部切口游离胃;颈部食管胃吻合.结果：33例均成功经VATS切除食管肿瘤.手术时间平均2.5h,其中VATS游离时间1.0h,胸腔出血量平均120ml,清扫淋巴结平均17.1个,其中胸部淋巴结8.6个.平均住院时间11.2d.术后发生心率失常2例,肺部感染5例,无死亡.结论：完全采用VATS对Ⅰ、Ⅱ期食管癌切除是可行的,近期手术效果较好.

Experience of video-assisted thoracoscopic surgery for esophageal carcinoma

Objective：To summarize the clinical experience of esophagectomy with video assisted thoracoscopic surgery （VATS） ,and to evaluate the postoperative effect. Methods： From January 1998 to December 2009,33 patients with esophageal carcinoma underwent esophagecotomy by video - assisted thoracoscopic esophagectomy . Male 21 ,female 12. Median age was 65 years （ range 37 - 83 ）. Average length of the tumor was 4.8cm; all cases were squamous cell carcinoma. The tumor located at superior thorac segment in 7 cases, middle segment in 13 cases and lower segment in 13 cases. TNM staging of carcinoma was as T1N0M0（n =5） ,T1N1M0（n =8） ,TeNoM0（n = 10）, T2N1 M0 （n = 8 ）, T3N1 M0 （n = 2 ）. VATS approach was used to mobilize the intrathoracic esophageal tumor. The stomach was mobilized via abdominal incision and the esophagogastric anastomosis was performed in the neck. Results： All cases were successfully resected by VATS. Average operation duration was 1.0 hour. The hospital stay was 11.2 days. Mean 17.1 lymph nodes were excised per case. There were 2 cases of atrial fibrillation,and 5 cases pneumonia,no death after the operation. Conclusion： VATS is a safe and feasible minimally invasive approach for esoph- agectomy with satisfied effects.