微创食管癌手术

Minimally Invasive Esophageal Cancer Surgery.

作者信息

Peng June S, Kukar Moshim, Mann Gary N, Hochwald Steven N

机构信息

Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY 14203, USA.

出版信息

Surg Oncol Clin N Am. 2019 Apr;28(2):177-200. doi: 10.1016/j.soc.2018.11.009. Epub 2019 Feb 2.

DOI:10.1016/j.soc.2018.11.009

PMID:30851822

Abstract

Laparoscopic and thoracoscopic or robotic-assisted minimally invasive esophagectomy offers benefits in decreased postoperative complications and faster recovery. The choice of operation depends on patient and surgeon factors. McKeown or 3-field esophagectomy requires dissection in the abdomen, chest, and neck, with a cervical anastomosis. Ivor Lewis esophagectomy is performed with abdominal and right chest dissection and intrathoracic anastomosis. Transhiatal or transmediastinal esophagectomy is performed with abdominal and cervical dissections and a cervical anastomosis and is preferential in patients with significant pulmonary risk factors. Preparation and operative conduct for laparoscopic and robotic approaches for these operations, and the expected postoperative recovery are detailed.

摘要

腹腔镜、胸腔镜或机器人辅助的微创食管切除术在减少术后并发症和加快恢复方面具有优势。手术方式的选择取决于患者和外科医生的因素。麦克尤恩或三野食管切除术需要在腹部、胸部和颈部进行解剖，并进行颈部吻合。艾弗·刘易斯食管切除术通过腹部和右胸解剖以及胸内吻合来完成。经裂孔或经纵隔食管切除术通过腹部和颈部解剖以及颈部吻合来进行，对于有显著肺部危险因素的患者更为适用。详细介绍了这些手术的腹腔镜和机器人手术入路的准备、手术操作以及预期的术后恢复情况。