Thairu N, Biswas S, Abdulaal Y, Ali H
Department of Surgery, Maidstone Hospital, Hermitage Road, Kent, ME16 9QQ, UK.
Surg Endosc. 2007 Oct;21(10):1887-90. doi: 10.1007/s00464-007-9292-y. Epub 2007 May 24.
The benefits of laparoscopic procedures over the traditional open technique for esophagectomy in the management of esophageal cancer are well documented. A disadvantage of the laparoscopic technique is longer surgery, particularly in the early part of a surgeon's "learning curve." In a two-stage (Ivor-Lewis) procedure, performance of the esophagogastric anastomosis within the chest can be a "rate-limiting step." A circular stapler is used, which requires placement of a purse-string suture or a manually-tied knot around in the transected proximal esophagus to secure the anvil in place. This is technically demanding and time-consuming in the laparoscopic setting. The authors have devised a method that obviates the need for a purse string or knot, simplifying the intrathoracic esophagogastric anastomosis while still achieving a safe anastomosis.
在食管癌治疗中，腹腔镜手术相较于传统开放食管切除术的优势已有充分文献记载。腹腔镜技术的一个缺点是手术时间较长，尤其是在外科医生“学习曲线”的早期阶段。在两阶段（艾弗 - 刘易斯）手术中，胸腔内食管胃吻合术可能是一个“限速步骤”。使用圆形吻合器时，需要在横断的近端食管周围放置荷包缝线或手工打结，以固定吻合器砧座。在腹腔镜手术中，这在技术上要求较高且耗时。作者设计了一种方法，无需荷包缝线或打结，简化了胸腔内食管胃吻合术，同时仍能实现安全吻合。
