[1]田文鑫 佟宏峰* 孙耀光 吴青峻 马超 焦鹏 于瀚博 黄川.单操作孔胸腔镜胸段食管癌手术42例报告[J].中国微创外科杂志,2019,01(10):890-893.
　Tian Wenxin,Tong Hongfeng,Sun Yaoguang,et al.Single-utility Port Video-assisted Thoracoscopic Surgery for Esophageal Cancer: Report of 42 Patients[J].Chinese Journal of Minimally Invasive Surgery,2019,01(10):890-893.
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单操作孔胸腔镜胸段食管癌手术42例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年10期
页码:
890-893
栏目:
临床研究
出版日期:
2019-10-25

文章信息/Info

Title:
Single-utility Port Video-assisted Thoracoscopic Surgery for Esophageal Cancer: Report of 42 Patients
作者:
田文鑫 佟宏峰* 孙耀光 吴青峻 马超 焦鹏 于瀚博 黄川
（北京医院胸外科国家老年医学中心，北京100730）
Author(s):
Tian Wenxin;  Tong Hongfeng;  Sun Yaoguang;  et al.
Department of Thoracic Surgery, Beijing Hospital, Beijing 100730, China
关键词:
单操作孔; 电视胸腔镜手术; 食管癌
Keywords:
Single-utility port; Video-assisted thoracoscopic surgery; Esophageal cancer
文献标志码:
A
摘要:
目的探讨单操作孔胸腔镜食管游离技术在胸段食管癌手术中的应用效果。 方法回顾性分析2014年3月~2017年2月42例胸段食管癌三切口食管癌根治术资料。应用单操作孔胸腔镜行胸段食管游离，左侧侧俯卧折刀位，腔镜孔位于右腋中线第8肋间，操作孔位于右腋中线与腋前线之间第4肋间，用“缝合牵拉显露法”显露后纵隔，完整游离胸段食管，并行纵隔及食管周围淋巴结清扫。腹腔镜或开腹游离胃，制作管状胃。左颈部切口行胃食管颈部吻合。结果42例均在全胸腔镜下顺利完成胸段食管游离和纵隔、食管周围淋巴结清扫，无中转开胸或增加切口，围术期无死亡。手术时间（350.3±55.6）min，术后前3日引流量（853.9±386.9）ml，术后住院（18.7±8.7）d，清扫胸腔淋巴结（15.7±10.0）枚。术后2例消化道漏，2例肺部感染，并发症发生率9.5%（4/42）。36例随访6~60个月，中位时间31个月，复发转移7例。结论应用单操作孔胸腔镜技术行三切口食管癌根治术安全可行。“缝合牵拉显露法”有利于单操作孔胸腔镜手术的顺利实施。
Abstract:
ObjectiveTo evaluate the effect of single-utility port video-assisted thoracoscopic surgery for patients with thoracic esophageal cancer.MethodsA total of 42 patients’ information who underwent McKeown surgery with single-utility port VATS from March 2014 to February 2017 was retrospectively analyzed. During the thoracic procedure, the patients were placed forwardly in left lateral decubitus position. The video port was made at the eighth mid-axillary intercostal space, and the single-utility port was at the fourth intercostal space between antero-axillary and mid-axillary line. The posterior mediastinum was exposed by the “suture-drawing exposure” method, then the thoracic esophagus was carefully dissected and mediastinal lymphadenectomy was done. Gastric mobilization and gastric conduit formation were performed by laparoscopy or open laparotomy. Cervical anastomosis was made with a left cervical incision.ResultsForty-two patients of single-utility port VATS were included. All the operations were accomplished successfully, without conversion to thoracotomy or require of additional ports. The average surgery duration was (350.3±55.6) min; the volume of drainage of first three days after surgery was (853.9±386.9) ml; the length of hospital stay after surgery was (18.7±8.7) d; the number of lymph nodes dissected was 15.7±10.0. Two patients developed anastomotic leakage, and two patients developed lung infection. Follow-ups were conducted in the 36 patients for 6-60 months (median, 31 months). Recurrence or metastasis was found in 7 cases.ConclusionsSingle-utility port VATS is safe and feasible for McKeown surgery of thoracic esophageal cancers. The “suture-drawing exposure” method is available to smoothly accomplish single-utility port VATS.

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备注/Memo

备注/Memo:
*通讯作者，E-mail：tonghongfeng2002@sina.com
更新日期/Last Update: 2020-01-09