Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Division of Esophageal Surgery, National Cancer Center Hospital, Tokyo, Japan.
Jpn J Clin Oncol. 2021 Jul 1;51(7):1171-1175. doi: 10.1093/jjco/hyab045.
Hybrid endoscopy-assisted larynx-preserving esophagectomy is developed for cervical esophageal squamous cell carcinoma encroaching or extending above the upper esophageal sphincter. First, a cervical incision was surgically performed followed by cervical lymph node dissection. Second, the margin of cervical esophageal squamous cell carcinoma was endoscopically identified with iodine staining and marked endoscopically followed by semi-circumferential or circumferential endoscopic full-thickness excision around the lumen of the esophagus. The distal margin was surgically resected and reconstruction was performed. Among six consecutive patients with cervical esophageal squamous cell carcinoma undergoing hybrid endoscopy-assisted larynx-preserving esophagectomy, proximal surgical margin was histologically negative in five patients. During a median follow-up period of 15.5 months, all patients tolerated oral intake and were alive without evidence of recurrence. None of the patients experienced aspiration pneumonia, vocal disorder or postoperative anastomotic stricture. Hybrid endoscopy-assisted larynx-preserving esophagectomy could be a clinically feasible treatment for cervical esophageal squamous cell carcinoma providing accurate proximal resection margin with the benefit of laryngeal function preservation.
杂交内镜辅助保喉食管切除术是为颈段食管鳞癌侵犯或向上延伸超过食管上括约肌而开发的。首先，进行颈切口手术，然后进行颈淋巴结清扫。其次，用碘染色进行内镜下识别和标记颈段食管鳞癌的边缘，然后在内镜下围绕食管腔进行半环或环形内镜全层切除。切除远端边缘并进行重建。在连续 6 例接受杂交内镜辅助保喉食管切除术的颈段食管鳞癌患者中，5 例患者的近端手术切缘组织学检查为阴性。在中位随访 15.5 个月期间，所有患者均耐受口服摄入，无复发迹象，均存活。无患者发生吸入性肺炎、声音障碍或术后吻合口狭窄。杂交内镜辅助保喉食管切除术可能是一种可行的颈段食管鳞癌治疗方法，可提供准确的近端切除边缘，并保留喉功能。
