[1]胡志豪 李瑞欣 王灼印 王国俊**.单一颈部切口微创食管切除术的初步应用[J].中国微创外科杂志,2021,01(12):1091-1094.
 Hu Zhihao,Li Ruixin,Wang Zhuoyin,et al.Application of Minimally Invasive Esophagectomy With a Single Cervical Incision[J].Chinese Journal of Minimally Invasive Surgery,2021,01(12):1091-1094.
点击复制

单一颈部切口微创食管切除术的初步应用()
分享到:

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2021年12期
页码:
1091-1094
栏目:
临床研究
出版日期:
2021-12-25

文章信息/Info

Title:
Application of Minimally Invasive Esophagectomy With a Single Cervical Incision
作者:
胡志豪 李瑞欣 王灼印 王国俊**
(郑州大学第一附属医院胃肠外科,郑州450001)
Author(s):
Hu Zhihao Li Ruixin Wang Zhuoyin et al.
Department of Gastrointestinal Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, China
关键词:
微创食管切除术食管恶性肿瘤颈部切口
Keywords:
Minimally invasive esophagectomyEsophageal carcinomaCervical incision
文献标志码:
A
摘要:
目的探讨单一颈部切口微创食管切除术治疗食管癌的可行性和安全性。方法2019年3月~2020年6月我科采用单一颈部切口微创食管切除术治疗食管癌18例,胸腔镜下游离食管和清扫淋巴结,全腹腔镜游离胃、清扫淋巴结并制作管状胃,经单一颈部切口取出标本,吻合食管与管胃。结果18例均顺利完成手术,手术时间252~391 min, 平均301 min。术中出血量90~280 ml, 平均160 ml。淋巴清扫(27.2±6.3)枚。术后肛门排气时间2~10 d,平均4 d。术后住院时间8~21 d,平均12.5 d。术后第1、2、3天疼痛视觉模拟评分(Visual Analogue Scale,VAS )分别为(2.6±0.3),(3.8±0.7),(3.1±1.1)分。术后3例吻合口漏,其中2例经介入治疗恢复,1例经延长胃管拔除保守治疗恢复。18例术后随访9~20个月,平均12个月,1例术后18个月复发,余17例无疾病进展。结论单一颈部切口微创食管切除术可行,安全。
Abstract:
ObjectiveTo investigate the feasibility and safety of minimally invasive esophagectomy(MIE) with a single cervical incision in the treatment of esophageal carcinoma.MethodsFrom March 2019 to June 2020, 18 cases of esophageal carcinoma were treated by MIE with a single cervical incision. We mobilized the esophagus and dissected lymph nodes via thoracoscopy. Total laparoscopic dissociation of the stomach, dissection of lymph nodes and production of tubular stomach were performed. The specimens were taken out through a single neck incision and the esophagus and tube stomach were anastomosed.ResultsAll the 18 cases of operations were successfully performed. The operative time ranged 252-391 min, with a mean of 301 min. The intraoperative blood loss ranged 90-280 ml, with a mean of 160 ml. The number of lymph nodes dissection was 27.2±63. The first flatus after operation was 2-10 d, with a mean of 4 d. The postoperative hospital stay was 8-21 d, with a mean of 12.5 d. The Visual Analogue Scale (VAS) scores on postoperative day 1, day 2, day 3 were (2.6±0.3),(3.8±0.7),and (3.1±1.1) points, respectively. Anastomotic leakage occurred in 3 cases. Two cases recovered after interventional treatment while 1 case recovered by conservative treatment. Followups were conducted in the 18 patients for 9-20 months (mean, 12 months). One case recurred 18 months after operation with remaining 17 cases being progressionfree.ConclusionMIE with a single cervical incision is feasible and effective.

参考文献/References:

[1]Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin,2018,68(6):394-424.
[2]Straatman J, van der Wielen N, Cuesta MA, et al. Minimally invasive versus open esophageal resection: Threeyear followup of the previously reported randomized controlled trial: the TIME trial. Ann Surg,2017,266(2):232-236.
[3]Triantafyllou T, Wijnhoven B. Current status of esophageal cancer treatment. Chin J Cancer Res,2020,32(3):271-286.
[4]陈保富,孔敏,朱成楚,等.腔镜辅助下McKeown术式切除食管癌507例临床体会.中华胸心血管外科杂志,2013,29(6):334-338.
[5]Low DE, Alderson D, Cecconello I, et al. International consensus on standardization of data collection for complications Associated with esophagectomy: Esophagectomy Complications Consensus Group (ECCG). Ann Surg,2015,262(2):286-294.
[6]查鹏.微创食管切除术的发展历程和进展.中国微创外科杂志, 2020,20(1):62-65.
[7]Khan O, Nizar S, Vasilikostas G, et al. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, openlabel, randomised controlled trial. J Thorac Dis, 2012,4(5):465-466.
[8]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.
[9]Jin Y, Lu X, Xue L, et al. Retrospective comparison of two minimally invasive esophagectomy in the treatment of esophageal cancer: Pneumatic mediastinoscopy versus thoracoscopy. J Laparoendosc Adv Surg Tech A,2019,29(5):638-642.

备注/Memo

备注/Memo:
基金项目:河南省科技攻关项目(22170153)**通讯作者,Email:fccwanggj@zzu.edu.cn
更新日期/Last Update: 2022-04-07