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目的探讨胸腹腔镜食管癌切除术的近期疗效。方法选取食管癌患者229例,采用胸腹腔镜联合切除。术中全身麻醉,单腔气管插管。首先取左侧俯卧位,胸腔镜游离食管,清扫淋巴结;然后改平卧位,腹腔镜游离胃;最后行左颈部食管胃器械吻合。结果 229例患者均在腔镜下完成食管及胃游离,无中转开胸开腹,清扫淋巴结(25.6±6.8)枚。术后发生颈部吻合口瘘28例(12.2%),喉返神经损伤8例(3.5%),心肺并发症11例(4.8%),残胃气管瘘1例(0.4%),心肺功能衰竭死亡1例(0.4%)。无乳糜胸,无胸内瘘。结论胸腹腔镜食管癌切除术安全可行,近期疗效好。
Objective To investigate the short-term curative effect of thoracoscopic laparoscopic esophagectomy. Methods 229 cases of esophageal cancer patients were selected, combined thoraco-laparoscopic resection. Intraoperative anesthesia, single lumen tracheal intubation. First take the left prone position, thoracoscopic free esophageal, lymph node dissection; and then change supine, laparoscopic free stomach; the last line of the left cervical esophagogastric anastomosis. Results All the 229 patients underwent esophagectomy and gastric resection under endoscopy. There was no transit to open thoracotomy and lymph node dissection (25.6 ± 6.8). There were 28 cases (12.2%) of the anastomotic fistula after operation, 8 cases (3.5%) of recurrent laryngeal nerve injury, 11 cases of cardiopulmonary complications (4.8%), 1 case of residual gastric tracheal fistula (0.4%), cardiopulmonary failure 1 patient died (0.4%). No chylothorax, no thoracic fistula. Conclusion Laparoscopic laparoscopic resection of esophageal cancer is safe and feasible, the recent curative effect is good.