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83例电视胸腔镜下食管平滑肌瘤摘除术的临床分析

[Clinical analysis of 83 cases undergoing esophageal leiomyoma enucleation by video-assisted thoracoscopy].

作者信息

Zhang Chu, Wang Qun, Jiang Wei, Liu Yu

机构信息

Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2013 Sep;16(9):857-9.

Abstract

OBJECTIVE

To investigate the feasibility of video-assisted thoracoscopic surgery in the treatment of esophageal leiomyoma.

METHODS

Clinical data of 83 patients with esophageal leiomyoma from December 2002 to August 2012 treated by video-assisted thoracoscopic surgery were retrospectively analyzed.

RESULTS

Video-assisted thoracoscopic leiomyoma enucleations were performed in 82 patients. One patient was converted to thoracotomy to repair the esophageal mucosa and two patients required intraoperative mucosal repair by video-assisted thoracoscopic surgery for esophageal mucosa rupture. The mean operative time was 83.0 min (range, 40-300 min), and the mean blood loss was 52.4 ml (range, 20-150 ml). The mean length of postoperative hospital stay was 5.8 d (range, 3-50 d). The mean tumor diameter was 3.3 cm (range, 0.8-12.0 cm). One case with postoperative esophageal fistula was cured by conservative treatment. Eighty patients were followed up for 2-117 months, and all the patients were free of dysphagia without recurrence or other related complications.

CONCLUSIONS

Thoracoscopic enucleation of esophageal leiomyoma can be performed effectively and safely. Thoracoscopic techniques for the removal of larger esophageal leiomyoma may be recommended as the treatment of choice in centers experienced with minimally invasive surgery.

摘要

目的

探讨电视胸腔镜手术治疗食管平滑肌瘤的可行性。

方法

回顾性分析2002年12月至2012年8月采用电视胸腔镜手术治疗的83例食管平滑肌瘤患者的临床资料。

结果

82例患者行电视胸腔镜下平滑肌瘤摘除术。1例中转开胸修复食管黏膜,2例因食管黏膜破裂在电视胸腔镜手术中需行术中黏膜修复。平均手术时间为83.0分钟(范围40 - 300分钟),平均失血量为52.4毫升(范围20 - 150毫升)。术后平均住院时间为5.8天(范围3 - 50天)。平均肿瘤直径为3.3厘米(范围0.8 - 12.0厘米)。1例术后食管瘘患者经保守治疗治愈。80例患者随访2 - 117个月,所有患者均无吞咽困难,无复发或其他相关并发症。

结论

电视胸腔镜下食管平滑肌瘤摘除术可有效、安全地进行。对于有微创手术经验的中心,推荐采用电视胸腔镜技术切除较大的食管平滑肌瘤作为首选治疗方法。

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