[1]孔繁成,隋为伟*,初立臣,等.胸腔镜食管癌IvorLewis手术10例报告[J].中国微创外科杂志,2017,17(08):752-760.
　Kong Fancheng,Sui Weiwei,Chu Lichen,et al.Thoracoscopic IvorLewis Operation for Esophageal Carcinoma: Report of 10 Cases[J].Chinese Journal of Minimally Invasive Surgery,2017,17(08):752-760.
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胸腔镜食管癌IvorLewis手术10例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年08期
页码:
752-760
栏目:
经验交流
出版日期:
2017-08-20

文章信息/Info

Title:
Thoracoscopic IvorLewis Operation for Esophageal Carcinoma: Report of 10 Cases
作者:
孔繁成; 隋为伟*; 初立臣; 房长坤; 夏冰; 孙超
辽宁省庄河市中心医院胸外科，庄河116400
Author(s):
Kong Fancheng;  Sui Weiwei;  Chu Lichen;  et al.
Department of Thoracic Surgery, Zhuanghe Central Hospital, Zhuanghe 116400, China
关键词:
胸腔镜; 胸内吻合术; 食管癌
Keywords:
Thoracoscopy; Anastomosis in chest cavity; Esophageal carcinoma
文献标志码:
B
摘要:
目的探讨胸腔镜食管癌IvorLewis手术的可行性与安全性。方法我院2014年1月~2016年1月行胸腔镜下食管癌切除胸内吻合术10例。开腹游离胃，清除腹腔淋巴结。用TL90直线缝合器做管状胃。胸腔镜下游离食管，清除胸腔淋巴结，用普通管状吻合器行管状胃、食管胸内吻合术。结果10例均在胸腔镜下完成手术，无中转开胸。腹部手术时间70~90 min，平均81 min；胸部手术时间180~310 min，平均210 min。清扫淋巴结15~28枚，平均19.5枚；阳性4例10枚（阳性率4.7%，10/211）。无吻合口漏、吻合口狭窄、呼吸衰竭、乳糜胸及围手术期死亡发生。术后病理：10例均为鳞癌，根据AJCC第7版（2009）病理分期：Ⅱ期7例（T2N0M0 6例，T2N1M0 1例），ⅢA期3例（T3N1M0 3例）。10例随访3~27个月，中位数19.5月，无转移、复发，无明显吞咽困难症状。结论胸腔镜食管癌IvorLewis手术安全、可行。
Abstract:
ObjectiveTo explore the feasibility and safety of thoracoscopic IvorLewis operation for thoracic esophageal cancer.MethodsTen patients with thoracic esophageal cancer underwent thoracoscopic IvorLewis operation from January 2014 to January 2016. Under open surgery, the stomach was mobilized and abdominal lymph nodes were removed. A tubelike stomach was made by using TL90 straight line suture. The esophagus was disconnected and the thoracic lymph nodes were resected under thoracoscope. The tubelike stomach and esophagus were anastomosed by tubular stapler.ResultsNo case was converted to open esophagectomy. The abdominal operation time ranged from 70 to 90 min, with a mean of 81 min. And the thoracoscopic operation time ranged from 180 to 310 min, with a mean of 210 min. A total of 15-28 lymph nodes were removed in each patient (mean, 19.5) and a total of 10 lymph nodes in 4 cases turned out to be positive ［positive rate, 4.7% (10/211)］. No patient suffered from anastomotic fistula, anastomotic stricture, respiratory failure, chylothorax or death during hospitalization. Pathology after operation showed 10 cases of squamouscell cancer. According to the AJCC (the seventh edition of 2009), pathology analysis showed 7 cases of Ⅱstage (6 cases of T2N0M0 and 1 case of T2N1M0) and 3 cases of ⅢA stage (3 cases of T3N1M0). All of the patients received a followup time for 3-27 months with a median of 19.5 months, during which no metastasis, recurrence or dysphagia was observed.ConclusionThoracoscopic IvorLewis operation for thoracic esophageal cancer is feasible and safe.

参考文献/References:

[1]张强.胸腹腔镜联合手术治疗食管癌的现状.中国微创外科杂志,2013,13(9)：852-855.
[2]艾波，廖永德，付向宁.全胸腔镜下食管胃胸内吻合术治疗中下段食管癌的技术探讨.中国微创外科杂志,2013,13(5)：394-397.
[3]Butler N，Collins S，Memon B，et al. Minimally invasive oesophagectomy: current status and future direction. Surg Endosc,2011,25(7):2071-2083.
[4]吴汉然，解明然，柳常青，等.微创IvorLewis术与McKeown术治疗胸中下段食管癌近期疗效比较.中华胸心血管外科杂志，2014，30(11)：649-652.
[5]Gao Y，Wang Y，Chen L，et al. Comparison of open threefield and minimallyinvasive esophagectomy for esophageal cancer. Interact Cardiovasc Thorac Surg,2011,12(3):366-369.
[6]Santillan AA，Farma JM，Meredith KL，et al. Minimally invasive surgery for esophageal cancer. J Natl Compr Canc Netw,2008,6(9):879-884.
[7]曹庆东，代伟，杨军，等.经口置入钉砧头系统 (OrVil) 在全腔镜下食管癌根治术中消化道重建中的应用体会.中国微创外科杂志，2010，10(12):1130-1132.
[8]Nguyen NT，Hinojosa MW，Smith BR，et al. Thoracoscopic construction of an intrathoracic esophagogastric anastomosis using a circular stapler: transoral placement of the anvil. Ann Thorac Surg,2008,86(3):989-992.
[9]Nguyen NT，Follette DM，Lemoine PH，et al. Minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg,2001,72(2):593-596.
[10]吴奇勇，童继春，王勇，等.胸、腹腔镜联合手术治疗食管癌的临床对比.中国微创外科杂志，2012，12 (12)：1107-1109.
[11]郑春鹏，傅俊惠，吴智勇，等.侧俯卧位胸、腹腔镜食管癌切除术的临床应用价值.中国微创外科杂志，2013，13(3)：221-223.

备注/Memo

备注/Memo:
*通讯作者，Email：435666219@qq.com
更新日期/Last Update: 2017-11-22