国际病理科学与临床杂志2012，Vol.32Issue(6)：512-515,4.DOI:10.3969/j.issn.1672-7347.2012.06.010
胸腔镜食管癌切除术临床经验总结
Clinical experience of esophagectomy with video-assisted thoracoscopic surgery
李小兵 1师晓天 1冯瑞庆 1许冰 1王虎 1王开洲 1张新华 1吴相稳1
作者信息
- 1. 河南安阳市肿瘤医院胸二科,河南安阳455000
- 折叠
摘要
Abstract
Objective: To summarize the clinical experience of video-assisted thoracoscopic surgery (VATS) in esophagectomy and to evaluate the short-term effect of VATS esophageal resection. Methods: A retrospective analysis of 76 cases of clinical data from July 2010 to February 2012 in Anyang Tumor Hospital was carried out. All patients underwent VATS esophageal resection. Forty-one males and 35 females were included with an average age of 62 (from 48 to 78) years old. The mean tumor length was 3.6 cm. There were 72 patients with squamous cell carcinoma, 2 patients with carcinosarcoma, 1 patient with small cell endocrine carcinoma, and 1 patient with cardia adenocarcinoma coupled with severe atypical hyperplasia of upper thoracic esophageal mucosa. The upper, middle, and lower chest segment esophageal cancer accounted for 10, 55, and 10 patients respectively with 1 gastric cardia adenocarcinoma. Eight patients were given 2 cycles' chemotherapy before surgery, 1 given 3 cycles, 1 given pre-operative radiotherapy, and 2 relapsed after radiotherapy. The tumor-lymph node-metastasis (TNM) staging indicated: T1N0M0 in 15 patients, T1N1M0 in 2 patients, T1N2M0 in 2 patients, T2N0M0 in 9 patients; T2N1M0 in 8 patients, T2N2M0 in 1 patient, T3N0M0 in 19 patients, T3N1M0 in 10 patients, T3N2M0 in
5 patients, T3N3M0 in 2 patients, and T4aNlM0 in 3 patients. The operation contained 3 steps: Resection of esophagus with right-chest VATS and cleaning of thoracic lymph node, the separation of the stomach by upper-middle abdominal incision and the application of tubular stomach, and esophagogastrostomy by end-side with stapling at the neck. Results: Of the 76 cases of VATS esophageal resection, 70 were completed successfully, while
6 required an intra-operative assisted muscle sparing incision (MSI). The mean surgical procedure lasted 264 min with the mean volume of intra-operative bleeding standing at 210 mL and 14 lympho-nodes resected averagely, of which, 8.97 was located in chest. The mean length of hospital stay was 23 d. Post-operative pulmonary infection was found in 11 patients but cured after the treatment. Recurrent laryngeal nerve was injured in 7 patients. Neither peri-operative death nor anastomotic leakage was seen. Conclusion: Esophageal resection with VATS is applicable to the patients with esophageal cancer before T3 stage in TNM staging.关键词
食管癌/电视胸腔镜/食管切除术Key words
esophageal cancer/ video-assisted thoracoscopy/ esophagectomy引用本文复制引用
李小兵,师晓天,冯瑞庆,许冰,王虎,王开洲,张新华,吴相稳..胸腔镜食管癌切除术临床经验总结[J].国际病理科学与临床杂志,2012,32(6):512-515,4.
