胸腹腔镜联合食管癌根治术40例临床总结

Thoracoscopy combined with laparoscopy in treatment of esophageal cancer radical operation (40 cases)

摘要:

目的 探讨胸腹腔镜联合在食管癌根治性切除术中的应用和应注意的问题。方法 回顾性分析2011年7月-2014年12月40例胸腹腔镜联合食管癌根治术的临床资料。结果 除1例因肿瘤明显外侵气管，1例因肿瘤明显外侵胸主动脉而中转小切口开胸完成手术外，其余38例顺利完成手术。术后颈部吻合口瘘2例，吻合口狭窄2例，声音嘶哑1例，无围手术期死亡。通过通讯和复诊随访6～36个月，2例患者术后10和24个月因局部复发死亡，1例出现锁骨上淋巴结转移行局部放射治疗后缓解。失访2例。结论 胸腹腔镜联合行食管癌根治术安全可靠、微创、恢复快，且近期疗效满意，值得临床推广应用。

Abstract:

Objective To explore and analyze the application and problems of esophageal cancer radical operation by thoracoscopy combined with laparoscopy. Methods From July, 2011 to December, 2014, clinical data of 40 patients undergoing esophageal cancer radical operation by thoracoscopy combined with laparoscopy were analyzed retrospectively. Results Except 2 cases being relayed to assisted small thoracic incision because of 1 case with clear tumor invading to trachea and 1 case with obvious tumor invasion to thoracic aortic artery, the remaining 38 cases were successfully completed operation. There were 2 cases with postoperative anastomotic fistula in the neck, 2 cases of anastomotic stenosis and 1 case of hoarseness, there was no perioperative death. Follow-up was within 36 months, 2 patients died 10 months and 24 months after surgery respectively, due to tumor local recurrence. 1 patient with supraclavicular lymph node metastasis underwent local radiation therapy. The remaining was all survival with relapse-free. Conclusions Esophageal cancer radical operation by thoracoscopy combined with laparoscopy is a good method with safety and reliability, minimal invasion, fast recovering, and satisfied recent curative effect. It is worthy of applying clinically.