东南大学学报（医学版）
東南大學學報（醫學版）
동남대학학보（의학판）
JOURNAL OF SOUTHEAST UNIVERSITY(MEDICAL SCIENCE EDITION)
2013年
5期
571-573
,共3页
电视胸腔镜手术%食管切除术%食管癌
電視胸腔鏡手術%食管切除術%食管癌
전시흉강경수술%식관절제술%식관암
video assisted thoracoscopic operation%esophageal resection%esophageal cancer
目的：探讨电视胸腔镜（ VATS）食管癌切除术及手辅助电视胸腔镜（ HVATS）食管癌切除术的方法及效果。方法：对51例食管中段癌患者予以VATS食管癌切除术，均行食管胃颈部吻合。其中15例在全胸腔镜下经右胸游离食管，经腹游离胃并制成管状胃，提至颈部与食管吻合；36例先经腹游离胃并制成管状胃，辅助手经腹部切口右肋弓下腹膜外进入右胸托肺及协助VATS游离食管，将胃提至颈部吻合。结果：VATS手术时间平均为200 min，HVATS手术时间平均为160 min。手术和术后恢复均顺利，无吻合口狭窄。1例HVAST手术者术后发生颈部吻合口瘘，颈部伤口敞开换药后痊愈。无围手术期死亡。结论：VATS食管癌切除术能达到常规开胸手术相同的手术效果，特别是HVATS食管癌切除术具有手术时间短、创伤小、并发症少、恢复快等优点。
目的：探討電視胸腔鏡（ VATS）食管癌切除術及手輔助電視胸腔鏡（ HVATS）食管癌切除術的方法及效果。方法：對51例食管中段癌患者予以VATS食管癌切除術，均行食管胃頸部吻閤。其中15例在全胸腔鏡下經右胸遊離食管，經腹遊離胃併製成管狀胃，提至頸部與食管吻閤；36例先經腹遊離胃併製成管狀胃，輔助手經腹部切口右肋弓下腹膜外進入右胸託肺及協助VATS遊離食管，將胃提至頸部吻閤。結果：VATS手術時間平均為200 min，HVATS手術時間平均為160 min。手術和術後恢複均順利，無吻閤口狹窄。1例HVAST手術者術後髮生頸部吻閤口瘺，頸部傷口敞開換藥後痊愈。無圍手術期死亡。結論：VATS食管癌切除術能達到常規開胸手術相同的手術效果，特彆是HVATS食管癌切除術具有手術時間短、創傷小、併髮癥少、恢複快等優點。
목적：탐토전시흉강경（ VATS）식관암절제술급수보조전시흉강경（ HVATS）식관암절제술적방법급효과。방법：대51례식관중단암환자여이VATS식관암절제술，균행식관위경부문합。기중15례재전흉강경하경우흉유리식관，경복유리위병제성관상위，제지경부여식관문합；36례선경복유리위병제성관상위，보조수경복부절구우륵궁하복막외진입우흉탁폐급협조VATS유리식관，장위제지경부문합。결과：VATS수술시간평균위200 min，HVATS수술시간평균위160 min。수술화술후회복균순리，무문합구협착。1례HVAST수술자술후발생경부문합구루，경부상구창개환약후전유。무위수술기사망。결론：VATS식관암절제술능체도상규개흉수술상동적수술효과，특별시HVATS식관암절제술구유수술시간단、창상소、병발증소、회복쾌등우점。
Objective:To explore the method and effect of video-assisted thoracoscopy and hand-assisted video-thoracoscopy for resection of esophageal cancer .Method:Fifty-one patients with mid-esophageal cancer underwent video-thoracoscopic esophagectomy through cervical esophagogastric anastomosis . Fifteen patients from them received thoracoscopy surgery to dissect esophagus , then gastric tube was made by laparotomy , and anastomosis was made in the neck .The other 36 patients received hand-assisted video-thoracoscopy , first of all the gastric tube was made by laparotomy , the dissection of esophagus was performed with the assiatance of hand to press down the lung , and the anastomosis was made in the neck .Results:The mean operative time of video-thoracoscopic esophagectomy was 200 min, and of hand-assisted video-thoracoscopy was 160 min.All patients′surgery and postoperative recovery were successfully with no anastomotic stricture .One patient who received hand-assisted video-thoracoscopy had cervical anastomotic fistula, which healed by dressing change through the neck incision .There was no perioperative mortality . Conclusion:It is suggeste that the outcome of video-assisted thoracoscopic resection of esophageal cancer is same as routine thoracic operation , with the advancements of shorter operative time , minimal invasion , less complications and quick recovery .
