胸腔镜下食管癌患者俯卧位行食管切除术治疗漏斗胸：两例报告

Thoracoscopic esophagectomy in the prone position for esophageal cancer patients with pectus excavatum: a report of two cases.

作者信息

Tsukada Tomoya, Kitano Yuto, Sugimoto Yuya, Kaji Masahide

机构信息

Department of Surgery, Toyama Prefectural Central Hospital, 2-78 Nishi Nagae, Toyama, 930-8550, Japan.

出版信息

Surg Case Rep. 2021 May 7;7(1):113. doi: 10.1186/s40792-021-01193-9.

DOI:10.1186/s40792-021-01193-9

PMID:33961153

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8105452/

Abstract

BACKGROUND

Pectus excavatum is a common thoracic deformity that can be encountered during thoracoscopic esophagectomy. Here, we report two cases of esophageal cancer complicated by pectus excavatum that were treated with thoracoscopic esophagectomy with the patients in the prone position.

CASE PRESENTATION

The first patient was a 64-year-old male diagnosed with esophageal cancer (cT3N0M0, Haller index 8.5) and underwent radical thoracoscopic esophagectomy in the prone position following neoadjuvant chemotherapy. The second patient was a 67-year-old male diagnosed with esophageal cancer (cT1bN0M0, Haller index 4.3), and the same procedure was performed in this patient. In cases of patients with a high Haller index, where securing the surgical field is difficult, preoperative computed tomography in the prone position can help surgeons to understand the mediastinal field of view and is safe.

CONCLUSIONS

Radical thoracoscopic esophagectomy in the prone position may be a surgical option in patients with pectus excavatum.

摘要

背景

漏斗胸是胸腔镜下食管切除术可能遇到的常见胸廓畸形。在此，我们报告两例漏斗胸合并食管癌患者，采用胸腔镜下食管切除术并使患者处于俯卧位进行治疗。

病例介绍

首例患者为一名64岁男性，诊断为食管癌（cT3N0M0，哈勒指数8.5），在新辅助化疗后于俯卧位接受了根治性胸腔镜下食管切除术。第二例患者为一名67岁男性，诊断为食管癌（cT1bN0M0，哈勒指数4.3），该患者也接受了相同的手术。对于哈勒指数较高、难以确保手术视野的患者，术前俯卧位计算机断层扫描有助于外科医生了解纵隔视野且安全。