Tinoco Renam, El-Kadre Luciana, Tinoco Augusto, Rios Rodrigo, Sueth Daniela, Pena Felipe
Department of Surgery, Hospital São José do Avaí, Itaperuna, Rio de Janeiro, Brazil.
Surg Endosc. 2007 Aug;21(8):1284-7. doi: 10.1007/s00464-007-9267-z. Epub 2007 Apr 24.
Laparoscopic transhiatal esophagectomy, indicated for benign and malignant esophageal diseases, is a complex operation, often associated with a high rate of morbidity and mortality. During the past decade this technique has became well accepted among specialized surgeons for the treatment of esophageal cancer, avoiding thoracotomy and reducing open access complications. The aim of the present study was to retrospectively analyze patients with esophageal cancer who underwent laparoscopic transhiatal esophagectomy.
From November 1993 to August 2006, 78 patients underwent laparoscopic transhiatal esophagectomy. There were 68 cases of esophageal cancer (57 males and 21 females, age range = 28-73 years) with a predominant rate of squamous cell carcinoma (60.2%).
The conversion rate was 6.4%. The mean operative time was 153 min with a 12.8% rate of cervical leak and a postoperative (30-day) mortality rate of 5.1%. The four-year survival rate was 19% as determined within a subgroup of 21 patients whose followup during the period was possible.
Laparoscopic transhiatal esophagectomy is a safe alternative for experienced professionals. This access can improve mortality, hospital stay, and other outcomes when compared with open methods.
腹腔镜经裂孔食管切除术适用于良性和恶性食管疾病，是一项复杂的手术，常伴有较高的发病率和死亡率。在过去十年中，这项技术已被专业外科医生广泛接受用于治疗食管癌，避免了开胸手术并减少了开放手术相关并发症。本研究的目的是回顾性分析接受腹腔镜经裂孔食管切除术的食管癌患者。
1993年11月至2006年8月，78例患者接受了腹腔镜经裂孔食管切除术。其中68例为食管癌患者（男性57例，女性21例，年龄范围28 - 73岁），鳞状细胞癌占主导比例（60.2%）。
中转开腹率为6.4%。平均手术时间为153分钟，颈部吻合口漏发生率为12.8%，术后（30天）死亡率为5.1%。在21例在此期间能够进行随访的患者亚组中，四年生存率为19%。
腹腔镜经裂孔食管切除术对于有经验的专业人员来说是一种安全的选择。与开放手术方法相比，这种手术途径可改善死亡率、住院时间及其他预后。
