Zaharie Florin, Mocan Lucian, Tomuş Claudiu, Zaharie Roxana, Bartos Dana, Iancu Cornel
Third Surgery Clinic, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Hepatogastroenterology. 2012 Sep;59(118):1835-9. doi: 10.5754/hge11790.
Evidence on the benefits of minimally invasive approach over traditional open procedure in gastrointestinal surgery is continuing to accumulate. This is also the case for esophageal surgery.Although laparoscopic esophageal surgery was initially reserved for benign pathology, the technical development, increasing experience with laparoscopic and thoracoscopic techniques and the theoretical advantages of minimally invasive surgery have widened the scope of minimally invasive approach to esophageal cancer. The surgical treatment of esophageal cancer often requires extensive procedures and is therefore, considered one of the most challenging and invasive procedure of gastrointestinal surgery. While transhiatal and transthoracic esophagectomy are common approaches for esophageal resection, data regarding the combined thoracoscopic and laparoscopic approach to esophagectomy are limited. The minimally invasive technique of esophagectomy to be described consists of three phases: thoracoscopic esophageal mobilization and mediastinal lymphadenectomy followed by laparoscopic gastric mobilization, abdominal lymphadenectomy and gastric conduit formation and finally retrieval of the resection specimen followed by an esophagogastric anastomosis via a left cervical incision.
在胃肠外科手术中，微创方法相较于传统开放手术的益处的证据正在不断积累。食管手术也是如此。尽管腹腔镜食管手术最初仅用于良性病变，但技术的发展、腹腔镜和胸腔镜技术经验的增加以及微创手术的理论优势，已扩大了食管癌微创方法的范围。食管癌的手术治疗通常需要广泛的操作，因此被认为是胃肠外科手术中最具挑战性和侵入性的手术之一。虽然经裂孔和经胸食管切除术是食管切除的常见方法，但关于胸腔镜和腹腔镜联合食管切除术的数据有限。本文所述的微创食管切除技术包括三个阶段：胸腔镜下食管游离和纵隔淋巴结清扫，随后进行腹腔镜下胃游离、腹部淋巴结清扫和胃管道形成，最后取出切除标本，然后通过左颈部切口进行食管胃吻合。
