Shiozaki Hitoshi, Imamoto Haruhiko, Shigeoka Hironori, Imano Motohiro, Yano Masahiko
Department of Surgery, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-sayama, Osaka 589-8511, Japan.
Gan To Kagaku Ryoho. 2003 Jul;30(7):923-8.
We have been successfully performing minimally invasive esophagectomy through a 10-cm thoracotomy and two trocar ports. Esophagectomy can be performed safely and efficiently via the thoracoscopy. We have also adapted hand assisted laparoscopic surgery (HALS) for the abdominal procedure through a 7-cm laparotomy and three trocar ports. One of the important points of esophagectomy for thoracic esophageal cancer is performing lymphadenectomy near either side recurrent laryngeal nerve. Another important point is to preserve the bronchial branch of the vagus nerve and both bronchial arteries if they are without cancerous invasion. We also preserve the azygos vein and the thoracic duct to minimize surgical invasion. Standard thoracotomy and laparotomy are significantly invasive procedures with potential complications and prolonged healing; minimally invasive esophagectomy has the potential to minimize morbidity and decrease healing time.
我们已成功通过10厘米的开胸手术和两个套管针端口进行微创食管切除术。通过胸腔镜可以安全有效地进行食管切除术。我们还采用了手辅助腹腔镜手术(HALS),通过7厘米的剖腹手术和三个套管针端口进行腹部手术。胸段食管癌食管切除术的一个要点是在双侧喉返神经附近进行淋巴结清扫。另一个要点是,如果迷走神经的支气管分支和两条支气管动脉未受癌侵犯,则予以保留。我们还保留奇静脉和胸导管,以尽量减少手术创伤。标准的开胸手术和剖腹手术是具有潜在并发症和愈合时间延长的显著侵入性手术;微创食管切除术有可能将发病率降至最低并缩短愈合时间。