【摘要】 目的:探讨胸腔镜辅助下中、上段食管癌根治术的可行性及安全性。方法:12例中、上段食管癌患者行胸腔镜辅助下食管癌根治术,胸段食管行右侧胸部胸腔镜下操作,游离食管,清扫纵隔淋巴结。腹腔镜下或上腹正中切口游离胃并制成管状胃,清扫胃周,胃左淋巴结,食管,胃行左颈部吻合。结果:12例食管癌患者手术均成功,无中转开胸,无围手术期死亡及严重并发症发生。平均清扫淋巴结(13±9)枚。手术时间(310±70)min,术中出血量(260±70)m L,术后72 h胸部切口疼痛采用疼痛数字评价量表(NRS)评分为3.45±1.18,胸部疼痛轻,早期即可下床活动。对患者进行门诊随访至今,未发现复发、转移及死亡病例。结论:胸腔镜辅助下行Ⅰ、Ⅱ期中、上段食管癌根治术安全、有效,在市级医院值得推广。更多还原

【Abstract】 Objective: To investigate the feasibility and safety of radical resection of upper or middle esophageal carcinoma by video-assisted thoracic surgery( VATS). Methods: Twelve patients with upper or middle esophageal cancer underwent esophagectomy by VATS. Resection of the thoracic esophagus was carried out at the right side of the chest under the thoracoscope,with the esophagus and mediastinal lymph nodes being dissected. Middle incision at the lower or upper abdomen was performed under the laparoscope to construct tubular stomach,around which the lymph nodes were dissected before anastomosis of the esophagus with the left neck of the stomach. Results: Operation was successful in the 12 cases,and no single case required conversion to thoracotomy. No perioperative death or severe complications occurred. Averagely,( 13 ± 9) lymph nodes were dissected. The operative time was( 310 ± 70)min,and intraoperative blood loss was( 260 ± 70) m L. By Numerical Rating Scale( NRS) 72 hours after the operation,the incision pain at the chest was3. 45 ± 1. 18. The follow-up so far showed no relapse,no metastasis and no death. Conclusion: Radical resection of the esophageal caner by video-assisted esophagectomy may be safe and effective for the cancer at stage Ⅰ and Ⅱ,which is wider recommended in hospitals in municipal level.更多还原