关键词: 食管肿瘤, 胸腹腔镜, 食管切除术

Abstract:

Objective To evaluate of safety and feasibility of thoracoscopic and laparoscopic esophagectomy for the treatment of esophageal carcinoma.Methods Retrospective analyses were performed on chest combined with laparoscopy in the treatment of 20 patients with esophageal cancer information from september 2013 to July 2014.The patients were placed at a left lateral decubitus position,with the thoracoscopic mobilization of the intrathoracic esophagus and lymph node dissection;then in the lithotomy position.Laparoscopic mobilization of the stomach and lymph node dissection were cleared.Finally we pulled out the gastric tube from the esophageal bed to the neck and made stapled esophagogastrostomy in the left neck.Results All patients were not to be opened thoracic surgery and abdominal surgery.The mean operation time for thoracoscopy was(90 ± 30)minutes,The mean operation time for laparoscopic was(65±20)minutes,The total operation time was(210±40)minutes.The thoracic blood loss ranged from 60 to 200mL(mean,110mL),The abdominal blood loss ranged from 30 to 100mL(mean,60mL).mean number of mediastinal lymph nodes resected was ranged from 8 to 15(11.2 per ease),mean number of abdominal lymph nodes resected was ranged from 6 to 12(8.4 per ease).Postoperative thoracic drainage was ranged from 200 to 650mL(mean,350mL).mean time to resume oral intake was ranged from 6 to 8 days(mean,7 days),mean postoperative hospital stay was ranged from 11 to 14 days(mean,12 days),All the patients were diagnosis for esophageal squamous cell cancer after operation.Postoperative pathologicalcat staging identified stage T_1~3N_0~1M₀.There was not tumor at the upper rejection margin and the lower margin.There was not anastomotic leak in postoperative.Postoperative lung infection in1 case.Postoperative recurrent laryngeal nerve injury in 1case.It was successfully followed up with durations 6 months.anastomotie stricture in 1 case after postoperative 3 months,And in endoscopic probe dilatation for patients with anastomotie stricture was successful in three times.20 cases were successfully followed up with durations ranged from 2 to 10 months.There was not spreaded and died in cases.Conclusion Combined thoracoscopic and laparoscopic esophagectomy can reduce trauma and postoperative complications,which is safe and feasible therapeutic method.

Key words: Esophageal carcinomas, Thoracoseopy laparoseopy, Esophagcetomy