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目的 探讨食管内翻拔脱术辅助电视胸腔镜手术治疗食管癌的临床效果。方法 对 18例食管癌患者在不开胸行食管内翻拔脱术的基础上 ,辅助胸腔镜切除食管肿瘤。其中 10例用吻合器吻合 ,8例用手工吻合。结果 全组手术过程顺利 ,无手术死亡 ,无吻合口狭窄或吻合口漏。 1例术后出院 1个月不明原因死亡 ,另 1例出院 8个月后出现颈部吻合口瘘 ,经保守治疗 ,治愈出院。 16例随访 3～ 9个月未见复发。结论 食管内翻拔脱术联合胸腔镜食管癌切除术具有创伤小、并发症少 ,而且胸腔镜食管癌切除术能直视下分离病变和清扫周围淋巴结 ,避免单纯内翻拔脱术的盲目性。适用于Ⅱ、Ⅲ期食管癌患者 ,还可以增加心肺功能不全食管癌患者的手术机会和提高手术安全性。
Objective To investigate the clinical effect of esophageal varus extraction assisted by video-assisted thoracoscopic surgery for esophageal cancer. Methods 18 cases of esophageal cancer patients without esophagectomy on the basis of extraction, assisted thoracoscopic resection of esophageal tumors. Ten of them were anastomosed with anastomat and 8 were anastomosed by hand. Results The whole operation was successful and no operative death occurred. No anastomotic stenosis or anastomotic leakage was found. One patient died of unexplained one month after discharge and another had anastomotic fistula after 8 months of discharge. After conservative treatment, he was discharged. 16 cases were followed up for 3 to 9 months without recurrence. Conclusions Esophageal varus extraction combined with thoracoscope esophagectomy has the advantages of less trauma and fewer complications. Thoracoscopic resection of esophageal cancer can directly isolate the lesion and clean the surrounding lymph nodes, and avoid the blindness of simple varus extraction . For Ⅱ, Ⅲ esophageal cancer patients, can also increase the chance of surgical treatment of patients with cardiopulmonary dysfunction esophageal cancer and improve surgical safety.