CAJ | 학술논문

目的：探讨全腔镜下Ivor Lewis食管癌根治术中普通管形吻合器钉砧安置新方法的可行性。方法2011年6月～2012年10月对20例胸中段食管癌在胸腔镜下安置钉砧到食管残端，以普通管形吻合器行胸膜顶胃食管吻合。结果手术时间平均200 min（150～300 min），术中出血平均180 ml（150～250 ml），清扫淋巴结平均18枚（12～44枚）。未行胸腹部辅助切口，围术期未输血，无手术相关并发症，未发生吻合口漏。术后病理上、下切缘均末见癌累及。患者术后恢复良好，术后平均10 d（8～12 d）出院。20例随访6个月，均未发生手术相关并发症，进食正常。结论利用新方法放置钉砧行胸腹腔镜下Ivor Lewis食管癌根治术可行，近期疗效满意。
목적：탐토전강경하Ivor Lewis식관암근치술중보통관형문합기정침안치신방법적가행성。방법2011년6월～2012년10월대20례흉중단식관암재흉강경하안치정침도식관잔단，이보통관형문합기행흉막정위식관문합。결과수술시간평균200 min（150～300 min），술중출혈평균180 ml（150～250 ml），청소림파결평균18매（12～44매）。미행흉복부보조절구，위술기미수혈，무수술상관병발증，미발생문합구루。술후병리상、하절연균말견암루급。환자술후회복량호，술후평균10 d（8～12 d）출원。20례수방6개월，균미발생수술상관병발증，진식정상。결론이용신방법방치정침행흉복강경하Ivor Lewis식관암근치술가행，근기료효만의。
Objective To explore the feasibility of a novel technique of anvil placement in combined use of laparoscopic and thoracoscopic Ivor Lewis esophagectomy. Methods From June 2011 to October 2012, we performed a novel technique of minimally invasive Ivor Lewis esophagogastrectomy in 20 patients with midthoracic esophageal cancer.The anvil was placed to connection with the esophageal stump under thoracoscopic vision, and an apical pleural stomach esophagus anastomosis was performed by using normal stapling. Results The mean operation time lasted for 200 minutes (150-300 minutes) with a mean blood loss of 180 ml (150-250 ml) without blood transfusion.The mean number of lymph nodes resected was 18 (12-44).No additional incision was required. There were no complications at post-operation and no anastomic leakage.The patient’s hospital stay lasted a mean of 10 days (8-12 days) .Follow-up reviews were conducted for 6 months and no recurrence was found in all the 20 patients. Conclusion Laparoscopic and thoracoscopic Ivor Lewis esophagectomy with novel technique of anvil placement for the treatment of esophageal carcinoma ensures the feasibility and safety.