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随着食管手术技术的不断发展,很多国外的肿瘤中心相继开展了旨在减少食管癌手术并发症和死亡率的食管微创手术技术。本文综述了微创食管癌手术的概念、手术方式、淋巴结清扫状况、并发症和死亡率,以及术后的生存质量的情况。目前怎样界定小创伤或微创仍然是一个非常困难的事情,也就是说食管微创手术目前还没有一个统一的标准,但是很多的资料表明食管微创外科有着很多的优势。在手术入路方面,越来越多的进行食管微创手术的医生采取了与当前开放Ivor-Lewis手术相似的方式,并获得了与开放手术相当甚至更好的淋巴结清扫。食管微创手术的术后生存质量的评价好于开放手术。在手术的并发症与死亡率方面与目前的开放手术相同。考虑到食管微创手术目前仍处于起步阶段,随着技术的不断完善,微创手术将获得更好的效果。当今的食管外科正在向着微创、彻底清扫的方向发展,可以预见在不远的将来,食管外科必将加入微创外科行列。
With the continuous development of esophageal surgery, many foreign cancer centers have successively launched esophageal minimally invasive surgical techniques aimed at reducing the complications and mortality of esophageal cancer. This article reviews the concept of minimally invasive esophageal cancer surgery, surgical procedures, lymph node dissection, complications and mortality, and postoperative quality of life. At present, it is still a very difficult task to define small trauma or minimally invasive surgery. In other words, there is not a uniform standard for minimally invasive esophageal surgery at present. However, many data indicate that there are many advantages in minimally invasive surgical treatment of esophageal tumors. As for the surgical approach, more and more doctors who underwent esophageal minimally invasive surgery took a similar approach to the current open Ivor-Lewis procedure and obtained lymphadenectomy equivalent to or better than open surgery. Postoperative quality of life of esophageal minimally invasive surgery is better evaluated than open surgery. Same as current open surgery in terms of surgical complications and mortality. Taking into account the minimally invasive esophageal surgery is still in its infancy, with the continuous improvement of technology, minimally invasive surgery will get better results. Today’s esophageal surgery is toward minimally invasive, thorough cleaning of the direction, it is foreseeable that in the near future, esophageal surgery will join the ranks of minimally invasive surgery.