CAJ | 학술논문

目的：食管良性肿瘤临床少见，且以食管平滑肌瘤为主。本文对40例经胸腹腔镜切除的食管良性肿瘤患者的临床资料进行分析总结，以期提高临床治疗水平。方法回顾性分析河北医科大学第四医院东院胸外科自2010年1月至2014年6月行胸腹腔镜治疗的40例食管良性肿瘤患者，其中平滑肌瘤38例，脂肪瘤和间质瘤各1例。男性26例，女性14例，年龄31～63岁，平均年龄(47.9±9.9)岁。位于食管上段9例，中段14例，下段14例，多发3例(2例2枚，1例5枚)。瘤体大小0.5～8.0 cm。结果全组全腔镜下完成34例，包括胸腔镜下30例，腹腔镜下4例，6例中转开胸或开腹。手术时间35～210分钟，平均(102.6±50.1)分钟；术中出血量(10～100) ml，平均（45.8±24.5) ml；术后引流管引流时间0～11天，平均(3.9±2.3)天；术后禁食时间2～6天，平均(3.1±1.1)天；术后住院天数3～13天，平均(6.8±2.5)天。4例患者术中发现食管黏膜破裂，其中1例于胸腔镜下行食管黏膜修补，另3例中转开胸或开腹修补，另有3例患者因肿瘤小，无法定位而中转开式手术。全组患者均痊愈出院，随访1～18个月发现，术后症状均得到有效改善，无食管瘘，无瘢痕性狭窄，无食管憩室等并发症。结论经胸腹腔镜切除食管良性肿瘤安全可靠，治疗效果肯定，且损伤小，术后恢复快，住院时间短，值得推广应用。
목적：식관량성종류림상소견，차이식관평활기류위주。본문대40례경흉복강경절제적식관량성종류환자적림상자료진행분석총결，이기제고림상치료수평。방법회고성분석하북의과대학제사의원동원흉외과자2010년1월지2014년6월행흉복강경치료적40례식관량성종류환자，기중평활기류38례，지방류화간질류각1례。남성26례，녀성14례，년령31～63세，평균년령(47.9±9.9)세。위우식관상단9례，중단14례，하단14례，다발3례(2례2매，1례5매)。류체대소0.5～8.0 cm。결과전조전강경하완성34례，포괄흉강경하30례，복강경하4례，6례중전개흉혹개복。수술시간35～210분종，평균(102.6±50.1)분종；술중출혈량(10～100) ml，평균（45.8±24.5) ml；술후인류관인류시간0～11천，평균(3.9±2.3)천；술후금식시간2～6천，평균(3.1±1.1)천；술후주원천수3～13천，평균(6.8±2.5)천。4례환자술중발현식관점막파렬，기중1례우흉강경하행식관점막수보，령3례중전개흉혹개복수보，령유3례환자인종류소，무법정위이중전개식수술。전조환자균전유출원，수방1～18개월발현，술후증상균득도유효개선，무식관루，무반흔성협착，무식관게실등병발증。결론경흉복강경절제식관량성종류안전가고，치료효과긍정，차손상소，술후회복쾌，주원시간단，치득추엄응용。
Obiectives Esophageal benign tumors are rare clinically, most of which are leiomyomas. In this paper, 40 cases of esophageal benign tumor who were treated by thoracoscopy or laparoscopy were analyzed retrospectively, with the aim to improve the level of clinical treatments. Methods A cohort of 40 patients with esophageal benign tumors who were treated by thoracoscopy or laparoscopy in the east department of thoracic surgery of the 4th hospital of Hebei Medical University from January 2010 to June 2014 were collected retrospec-tively, including 38 cases of leiomyoma, 1 case of lipoma and 1 case of stromal tumor. The patients consisted of 26 male and 14 female patients who ranged in age from 31 to 63 (47.9±9.9) years. Tumor location:upper 9 cases, middle 14 cases, lower 14 cases, multiple 3 cases (2 cases with 2 tumors and 1 case with 5 tumors). The size of tu-mors was from 0.5 cm to 8.0 cm. Results In all patients, 34 cases were finished by endoscopy, among which 30by thoracoscopy and 4 by laparoscopy. Six patients turned to open operation. The operation time was 35 to 210 min, with the average of (102.6±50.1) min. The blood loss was from 10 to 100 ml,with the average of (45.8±24.5) ml. The drainage time was from 0 to 11 days, with the average of (3.9±2.3) d. The fasting time was from 2 to 6 days, with the average of (3.1 ±1.1) d. Postoperative hospital stay was from 3 to 13 days;with the average of (6.8 ±2.5) d. There were 4 cases whose mucosas were broken during the operation. One was repaired by thoracoscopy, and the other 3 were turned to open operation. Three cases whose tumors were too small to be located by endoscopy were also turned to open operation. All patients were cured and dismissed from hospital and were followed up 1 to 18 months. The symptoms were effectively improved. There was no complication of fistula, scar stenosis, and divertic-ulum. Conclusions Esophageal benign tumor resected by thoracoscopy or laparoscopy is safe and reliable, with minor invasion, fast postoperative recovery, and shorter hospital stay. This technique should be widely applied.