CAJ | 학술논문

目的探讨电视胸腔镜(VATS)联合胃镜在食管平滑肌瘤治疗中的可行性及临床价值.方法采用电视胸腔镜(VATS)联合胃镜行食管平滑肌瘤摘除术36例,位于食管下段24例,食管中段10例,食管上段2例.肿瘤大小1.0 cm×1.2 cm～ 4.0 cm×4.5 cm.结果本组36例患者均在全胸腔镜下完成手术.1例术中发生食管黏膜破裂,全组患者术中手术时间(62.7±16.2)min,出血量(60.5±24.6)ml.术后胸腔引流管放置时间(2.1±1.3)d,开始进食时间为术后(2.4±1.8)d,术后住院时间(5.4±1.8)d.术后36例患者病理均为平滑肌瘤.除l例术中发生食管黏膜破裂外,余患者均无手术并发症和死亡发生.结论胸腔镜联合胃镜治疗食管平滑肌瘤的方法安全、有效,可作为食管平滑肌瘤外科治疗的首选手术方式.
목적 탐토전시흉강경(VATS)연합위경재식관평활기류치료중적가행성급림상개치.방법 채용전시흉강경(VATS)연합위경행식관평활기류적제술36례,위우식관하단24례,식관중단10례,식관상단2례.종류대소1.0 cm×1.2 cm～ 4.0 cm×4.5 cm.결과 본조36례환자균재전흉강경하완성수술.1례술중발생식관점막파렬,전조환자술중수술시간(62.7±16.2)min,출혈량(60.5±24.6)ml.술후흉강인류관방치시간(2.1±1.3)d,개시진식시간위술후(2.4±1.8)d,술후주원시간(5.4±1.8)d.술후36례환자병리균위평활기류.제l례술중발생식관점막파렬외,여환자균무수술병발증화사망발생.결론 흉강경연합위경치료식관평활기류적방법안전、유효,가작위식관평활기류외과치료적수선수술방식.
Objective To explore the feasibility and clinical value of video-assisted thoracoscopic (VATS) and gastroscopic cooperative surgery for treatment of esophageal leiomyoma.Methods From July 2003 to June 2013,36 patients with esophageal leiomyoma underwent thoracoscopic and gastroscopic cooperative surgery.The leiomyomas were located in the lower part of esophagns for 24 patients,middle for 10 and upper for 2 respectirely.The size of tumors ranged from 1.0 cm×1.2 cm to 4.0 cm×4.5 cm.Results All the 36 patients underwent enucleation of leiomyoma under video-assisted thoracoscopy.Only one patient required intraoperative mucosal repair for esophageal mucosa rupture.The mean operative time was 50 to 150 (62.7 ± 16.2)min,and the mean intraoperative blood loss was 40 to 100 (60.5±24.6) ml.The thoracic drainage duration was 2 to 6 (2.1±13)d,the time to start postoperative feeding was 1 to 7 (2.4±1.8)d.The postoperative hospital stay was 4 to 9 (5.4± 1.8)d.Pathological study confirmed leiomyoma in all of the 36patients.Except one patient with esophageal mucosa rupture,the other patients recovered without operative complications and death.Conclusion VATS and gastroscopic cooperative surgery for treatment of esophageal leiomyoma is safe and effective,and may be used as the primary option for surgical removal of esophageal leiomyomas.