CAJ | 학술논문

目的探讨胸腹腔镜经右胸食管癌根治术并右胸内吻合的手术方法及可行性.方法回顾性分析全胸腹腔镜下食管癌根治并右胸内吻合术的38例患者,腹腔镜下游离胃,腔内直线切割缝合器行管状胃成形并空肠造瘘；胸腔镜下游离中下段食管,将胃提至奇静脉弓水平,使用吻合器行胃-食管吻合.结果手术平均280 min,过程顺利,无中转开胸、腹手术病例.术中出血平均约120ml,所有病例均无肺部并发症,无吻合口瘘.1例出现胃排空障碍,1例出现乳糜胸,无死亡病例,均治愈出院.结论胸腹腔镜经右胸食管癌根治术并胸内吻合手术是安全可行的,并且具有创伤小、术中出血少、痛苦轻、术后恢复快等优点.
목적 탐토흉복강경경우흉식관암근치술병우흉내문합적수술방법급가행성.방법 회고성분석전흉복강경하식관암근치병우흉내문합술적38례환자,복강경하유리위,강내직선절할봉합기행관상위성형병공장조루；흉강경하유리중하단식관,장위제지기정맥궁수평,사용문합기행위-식관문합.결과 수술평균280 min,과정순리,무중전개흉、복수술병례.술중출혈평균약120ml,소유병례균무폐부병발증,무문합구루.1례출현위배공장애,1례출현유미흉,무사망병례,균치유출원.결론 흉복강경경우흉식관암근치술병흉내문합수술시안전가행적,병차구유창상소、술중출혈소、통고경、술후회복쾌등우점.
Objective To investigate the feasibility of combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity.Methods We retrospectively analyzed the clinical data of 38 patients who underwent esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity from October 2011 to August 2012.To remove the stomach in laparoscopic and the esophagus in thoracoscopy.The main portion of a gastric conduit is created using three to four firings of a linear stapler(Ethicon Endo-surgery,Cincinati,OH) and jejunum stoma.Gastric conduit was pulled into the chest cavity and anastomosed to the esophagus.Results The average operative time was 280 minutes,the mean operative blood loss was 120 ml.No patient required laparotomy.No pulmonary complications or anastomotic leaks occurred.One had gastric retention,another one had chylous hydrothorax.All patients were cured,no one dead in hospital.Conclusion Combined laparoscopic and thoracoscopic esophagectomy for esophageal carcinoma and gastro-esophageal anastomosis in right thoracic cavity is technically feasible and safe,minimized trauma,less operative blood loss and quick recovery.