摘要
目的总结电视胸腔镜(VATS)辅助经腹食管癌切除术的手术操作方法和临床治疗经验。方法37例食管癌患者。食管癌位于胸上段2例,胸中段22例,胸下段13例;肿瘤长度2～6cm。病理学分期:T2N0M04例,T2N1M08例,T3N0M05例,T3N1M020例。均经左胸入路,采用VATS辅助经腹食管癌切除,食管胃颈部吻合术。结果34例顺利完成手术,1例术中因肿瘤严重外侵中转开胸手术治疗,2例因氧饱和度偏低,中转VATS下辅助小切口食管癌切除术。手术时间120～190min,平均138min;胸腔操作时间25～55min,平均37min。各例清扫淋巴结2～15个,共187个,29例发现转移淋巴结。全组无死亡病例,术后发生声音嘶哑及肺部感染各1例。结论VATS辅助经腹食管癌切除术经左胸入路,手术操作比较简单,胸腔操作省时,并发症少,适合T3N1M0期以下的食管癌,并能达到与常规开胸手术相同的切除效果。
Objective To evaluate the experience and operation skill of clinical treatment with video-assistant thorascope (VATS) via abdomen in the treatment of oesophagus cancer. Methods Retrospective analysis of oesophagus cancer in 37 patients, average 59.5 years, 2 cases whose tumour location was at superior segment, 22 cases midpiece, and 13 cases inferior segment. Tumour length ranges from 2 to 6 cm. According to the pathematology, 4 were T 2N 0M 0, 8 were T 2N 1M 0, 5 were T 3N 0M 0, and 20 were T 3N 1M 0.All of them were resected and anastomosed in cervical part via abdomen with the help of VATS. Result All of the operations were successful. One case was transferred to open-thorax operation because of the severe tumour outside invasion, and 2 cases were transferred to small incision operation with the help of VATS. The operations lasted 120～190 minutes, with an average of 138 minutes. Operation time in thorax lasted 25～55 minutes, with an average of 37 minutes. 2～15 lymphs wre resected from each case, with a total of 187, and metastasis lymph gland was found in 29 . No death happened, with one case having hoarse voice and another having pulmonary infection after operation. Conclusion Oesophagus cancer resection via abdomen with the help of VATS was easy to be operated and with fewer complications. The technique fits for the oesophagus cancer below T 3N 1M 0, and could achieve the same result as open-thorax operation.
出处
《河南肿瘤学杂志》
2005年第3期191-192,共2页
Henan Journal of Oncology
关键词
电视胸腔镜(VATS)
胸腔镜手术
食管癌
胸内疾病
外科手术
video-assisted thoracoscope,thoracoscopic surgery
oesophagus cancer
intrathoracic diseases
surgical treatment
