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目的:总结侧俯卧位胸腔镜食管癌根治术的临床经验。方法:回顾性分析2013年9月至2015年6月,我院全胸腔镜治疗的食管癌患者31例。采用全身麻醉,双腔管气管插管,由同一组医师行侧俯卧位胸腔镜游离胸段食管并清扫纵隔淋巴结,开腹游离胃,直线切割缝合器制作管状胃,通过胸骨后路径上提管胃,食管胃左颈部吻合。结果:中转开胸4例,手术时间(4.5±1.8)h,术中出血量(150±60)ml,术后胸腔引流管放置时间(5±3)d,术后住院时间(11±5)d。5例患者术后出现并发症,其中颈部吻合口瘘2例,颈部吻合口狭窄1例,胸腔积液1例,声音嘶哑1例。结论:侧俯卧位胸腔镜食管切除术在技术上是安全、微创、可行的。
Objective: To summarize the clinical experience of side-down thoracoscopic esophagectomy for radical surgery. Methods: Thirty-one patients with esophageal cancer underwent thoracoscopic surgery in our hospital from September 2013 to June 2015 were retrospectively analyzed. The general anesthesia, double-lumen endotracheal intubation, the same group of physicians row prone prone thoracoscopy free thoracic esophageal and dissection of mediastinal lymph nodes, open abdominal free stoma, linear incision suture tube making stomach, Stomach, esophageal stomach left anastomosis. Results: Transferred thoracotomy was performed in 4 cases, operation time (4.5 ± 1.8) h, blood loss (150 ± 60) ml, postoperative chest drainage tube placement time (5 ± 3) days, postoperative hospital stay time (11 ± 5) d. Five patients had postoperative complications, including 2 cases of anastomotic leakage in the neck, 1 case of anastomotic stenosis in the neck, 1 case of pleural effusion and 1 case of hoarseness. Conclusion: Lateral prone thoracoscopic esophagectomy is technically safe, minimally invasive and feasible.