Liu Bo, Li Xu, Yu Min-Jie, Xie Jin-Bao, Liao Guo-Liang, Qiu Ming-Lian
Department of Thoracic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Ann Thorac Med. 2023 Jan-Mar;18(1):39-44. doi: 10.4103/atm.atm_205_22. Epub 2023 Jan 25.
As a novel alternative to the conventional minimally invasive esophagectomy (MIE) to treat esophageal cancer, single-port laparoscopic retrograde three-step gastric mobilization (SLRM) for esophageal reconstruction during MIE to treat esophageal cancer was attempted in our department. The aim of the present study was to explore the preliminary clinical outcomes and feasibility of this innovative surgery.
From March 2020 to November 2021, patients undergoing SLRM combined with four-port thoracoscopic McKeown esophagectomy for their esophageal cancers were reviewed. Gastric mobilization with abdominal lymph node dissection was performed through SLRM. The clinical characteristics and short-term outcomes were analyzed retrospectively.
A total of 120 patients underwent R0 resection without conversion to open surgery. The mean times needed for the thoracic part, abdominal part, and total operation were 43 ± 6 min, 60 ± 18 min, and 230 ± 20 min, respectively. The numbers of mediastinal and abdominal lymph nodes harvested were 13.2 ± 2.7 and 10.2 ± 2.5, respectively. Postoperative pneumonia was encountered in 10 (8.3%) patients. Anastomotic leakage occurred in 3 (2.5%) cases. Temporary vocal cord paralysis was reported in 20 (16.6%) cases. The mean length of hospital stay was 8.5 ± 4.6 days.
The SLRM is a technically feasible and safe treatment for patients with esophageal cancer. It can be considered an alternative method for patients, especially for the ones with obesity and gastric distension.
作为治疗食管癌的传统微创食管切除术（MIE）的一种新型替代方法，我们科室尝试了单孔腹腔镜逆行三步胃游离术（SLRM）用于MIE术中的食管重建以治疗食管癌。本研究的目的是探讨这种创新手术的初步临床疗效和可行性。
回顾性分析2020年3月至2021年11月期间接受SLRM联合四孔胸腔镜McKeown食管切除术治疗食管癌的患者。通过SLRM进行胃游离及腹部淋巴结清扫。对临床特征和短期疗效进行回顾性分析。
共有120例患者接受了R0切除，未中转开腹手术。胸部手术、腹部手术及总手术的平均所需时间分别为43±6分钟、60±18分钟和230±20分钟。清扫的纵隔和腹部淋巴结数量分别为13.2±2.7枚和10.2±2.5枚。10例（8.3%）患者发生术后肺炎。3例（2.5%）发生吻合口漏。20例（16.6%）报告有暂时性声带麻痹。平均住院时间为8.5±4.6天。
SLRM对食管癌患者是一种技术上可行且安全的治疗方法。它可被视为患者的一种替代方法，尤其是对于肥胖和胃扩张患者。
