【摘要】 目的总结胸腔镜下食管切除术治疗食管癌的初步体会。方法分析40例胸腔镜下食管切除术治疗食管癌的方法、手术并发症及近、远期疗效。结果胸腔镜下完成食管癌食管切除术40例,术中平均出血约220mL,清除淋巴结共计294枚,转移度15.3%;并发症发生率32.5%(13/40),全组无手术死亡。随访至2007年5月,失访2例,全组中位生存期51.0个月,1、2、3、4和5年累积生存率分别为89.5%、71.1%、63.2%、53.1%和43.8%。结论胸腔镜下可以满意地完成食管癌食管切除术及淋巴结清扫术。与传统剖胸食管切除术相比,该术式具有手术创伤小、手术出血少、术后疼痛轻等优点。但对病变外侵明显者应做充分术前分期评估并应慎重选用。更多还原

【Abstract】 【Objective】To share the experiences of video-assisted thoracoscopic(VATS) esophagectomy for the treatment of patients with esophageal carcinoma.【Methods】Forty patients with esophageal carcinoma underwent video-assisted thoracoscopic esophagectomy between Dec.2001 and May 2004.And the surgical skills,complications,and short-term and long-term results were analyzed.【Results】The average blood loss during the surgery was about 220 mL.And 294 lymph nodes were dissected,of which 15.3% was positive.13 out of 40(32.5%) were accompanied with complications,and there was no death postoperatively.All of the patients except 2 had been followed up till May 2007.The median survival time was 51.0 months,and 1,2,3,4,5 years survival rates were 89.5%,71.1%,63.2%,53.1%,and 43.8%,respectively.【Conclusions】The VATS esophagectomy provides us alternative surgery for the treatment of patients with esophageal carcinoma,which has less trauma,less blood loss,and slighter pain compared with esophagectomy under thoracotomy.The accurate TNM staging is necessary and additional precaution should be taken when the lesion is apparently invasive.更多还原