中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2012年
9期
934-937
,共4页
张真铭%王允%高永山%宋宇%马林
張真銘%王允%高永山%宋宇%馬林
장진명%왕윤%고영산%송우%마림
食管肿瘤%食管切除术%微创手术%胸腔镜%腹腔镜%纵隔镜
食管腫瘤%食管切除術%微創手術%胸腔鏡%腹腔鏡%縱隔鏡
식관종류%식관절제술%미창수술%흉강경%복강경%종격경
Esophageal neoplasms%Esophagectomy%Minimally invasive surgery%Thoracoscopy%Laparoscopy%Mediastinoscopy
目的 探讨微创手术治疗食管癌的可行性、安全性及临床应用价值.方法 回顾性分析2008年2月至2011年12月四川大学华西医院采用微创手术完成的160例食管癌病例的临床资料.结果 160例病例中男140例,女20例,平均年龄59.6岁.行胸腔镜腹腔镜联合食管切除术139例,腹腔镜纵隔镜联合食管切除术3例,腹腔镜辅助Ivor-Lewis术15例,胸腹腔镜联合IvorLewis 3例.手术时间230～780(平均364.0)min,术中出血量20～4000(平均286.2)ml；获得R0切除152例(95.0％),清扫淋巴结6～39(平均19.4)枚.中转开放手术11例(6.9％),其中开胸9例,开腹2例;术中并发症发生率为11.3％(18/160).重症监护室监护时间0～430 h(平均22.1)h,术后住院时间7～93(平均13.1)d；术后并发症发生率34.4％(55/160),术后30 d内死亡率1.2％(2/160),住院死亡率2.5％(4/160).结论 微创手术治疗食管癌在技术上安全可行,可取得相当于甚至优于传统手术的治疗效果.
目的 探討微創手術治療食管癌的可行性、安全性及臨床應用價值.方法 迴顧性分析2008年2月至2011年12月四川大學華西醫院採用微創手術完成的160例食管癌病例的臨床資料.結果 160例病例中男140例,女20例,平均年齡59.6歲.行胸腔鏡腹腔鏡聯閤食管切除術139例,腹腔鏡縱隔鏡聯閤食管切除術3例,腹腔鏡輔助Ivor-Lewis術15例,胸腹腔鏡聯閤IvorLewis 3例.手術時間230～780(平均364.0)min,術中齣血量20～4000(平均286.2)ml；穫得R0切除152例(95.0％),清掃淋巴結6～39(平均19.4)枚.中轉開放手術11例(6.9％),其中開胸9例,開腹2例;術中併髮癥髮生率為11.3％(18/160).重癥鑑護室鑑護時間0～430 h(平均22.1)h,術後住院時間7～93(平均13.1)d；術後併髮癥髮生率34.4％(55/160),術後30 d內死亡率1.2％(2/160),住院死亡率2.5％(4/160).結論 微創手術治療食管癌在技術上安全可行,可取得相噹于甚至優于傳統手術的治療效果.
목적 탐토미창수술치료식관암적가행성、안전성급림상응용개치.방법 회고성분석2008년2월지2011년12월사천대학화서의원채용미창수술완성적160례식관암병례적림상자료.결과 160례병례중남140례,녀20례,평균년령59.6세.행흉강경복강경연합식관절제술139례,복강경종격경연합식관절제술3례,복강경보조Ivor-Lewis술15례,흉복강경연합IvorLewis 3례.수술시간230～780(평균364.0)min,술중출혈량20～4000(평균286.2)ml；획득R0절제152례(95.0％),청소림파결6～39(평균19.4)매.중전개방수술11례(6.9％),기중개흉9례,개복2례;술중병발증발생솔위11.3％(18/160).중증감호실감호시간0～430 h(평균22.1)h,술후주원시간7～93(평균13.1)d；술후병발증발생솔34.4％(55/160),술후30 d내사망솔1.2％(2/160),주원사망솔2.5％(4/160).결론 미창수술치료식관암재기술상안전가행,가취득상당우심지우우전통수술적치료효과.
Objective To explore the feasibility,safety and clinical application value of minimally invasive esophagectomy(MIE).Methods Clinical data of 160 patients undergoing minimally invasive approach in the West China Hospital of Sichuan University between February 2008 and December 2011 were analyzed retrospectively.Results There were 140 males and 20 females with a mean age of 59.6 years.Approaches to esophagectomy were thoracoscopic and laparoscopic esophagectomy (n =139),thoracoscopic and mediastinoscopic esophagectomy (n =3),laparoscopicassisted Ivor Lewis resection (n=15),thoracolaparoscopic Ivor Lewis resection (n =3).The mean operative time was 364(range 230-780) min and the mean blood loss was 286.2(range 20 to 4000) ml.The tumor free resection margins (R0) were completely in 152 cases (95.0％).The mean lymph node harvested was 19.4 (range 6-39).There were 11 (6.9％) cases converted to open operation including 9 thoracotomy and 2 laparotomy.The intraoperative complication rate was 11.3％ (18/160).The average length of intensive care unit (ICU) stay was 22.1 (range 0 to 430) h and the average length of postoperative hospital stay was 13.1 (range 7-93 d).Postoperative complication occurred in 34.4％ of patients.The 30-day mortality was 1.2％ (2/160) and the overall mortality was 2.5％ (4/160).Conclusion MIE is technically feasible and safe for the treatment of esophageal carcinoma,which provides good or even better outcomes than open approach.
