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单孔胸腔镜微创食管癌切除术治疗食管癌

Single-Port Thoracoscopic Minimally Invasive Esophagectomy for Esophageal Cancer.

作者信息

Hu Weipeng, Yuan Yong, Chen Longqi

机构信息

Department of Thoracic Surgery, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, China.

出版信息

World J Surg. 2019 Feb;43(2):567-570. doi: 10.1007/s00268-018-4811-7.

Abstract

BACKGROUND

This study was to explore the safety and feasibility of single-port thoracoscopic esophagectomy for esophageal cancer.

METHODS

The patients were placed in left lateral prone position, and a 4-cm incision through the 4th-5th intercostal space was taken on the post-axillary line. Except for a surgical wound protector, no other special instruments were used for single-port technique. The 10-mm camera and two or three thoracoscopic instruments were used for the thoracic phase. Mobilization of stomach with celiac lymph node dissection was performed via multiple-port laparoscopic approach. Cervical double-layered anastomosis was completed by hand-sewn technique.

RESULTS

A total of twenty-eight patients with esophageal squamous cell carcinoma underwent the single-port thoracoscopic surgery. All of the patients underwent R0 resection. The median time taken for thoracic phase and total operation time were 126 min (range, 121-153) and the 253 min (range, 197-309), respectively. The median number of resected thoracic lymph nodes was 16 (range, 12-24). There were no deaths or severe postoperative complications in this study, with no conversion of minimally invasive surgery to open procedure.

CONCLUSIONS

Our preliminary results demonstrate that this technique is safe and feasible for treating esophageal cancer within an acceptable length of operation time, which does not compromise the surgical radicality.

摘要

背景

本研究旨在探讨单孔胸腔镜食管癌切除术的安全性和可行性。

方法

患者取左侧俯卧位,在腋后线第4-5肋间做一个4厘米的切口。除手术伤口保护器外,单孔技术未使用其他特殊器械。胸腔镜手术阶段使用10毫米摄像头和两到三把胸腔镜器械。通过多孔腹腔镜方法进行胃游离及腹腔淋巴结清扫。采用手工缝合技术完成颈部双层吻合。

结果

共有28例食管鳞状细胞癌患者接受了单孔胸腔镜手术。所有患者均行R0切除。胸腔镜手术阶段的中位时间和总手术时间分别为126分钟(范围121-153分钟)和253分钟(范围197-309分钟)。切除的胸腔淋巴结中位数量为16个(范围12-24个)。本研究中无死亡病例或严重术后并发症,无微创手术转为开放手术的情况。

结论

我们的初步结果表明,该技术在可接受的手术时间内治疗食管癌是安全可行的,且不影响手术根治性。

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