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目的探讨电视胸腔镜辅助手术在食管平滑肌瘤患者治疗中的应用价值。方法回顾性分析2002年6月至2009年1月第二军医大学附属长海医院87例食管平滑肌瘤患者在电视胸腔镜辅助下行食管平滑肌瘤摘除术的临床资料,其中男61例,女26例;年龄20～65岁,平均年龄38.2岁。食管中段平滑肌瘤66例,下段9例,上段12例。肿瘤最小直径约0.5cm,最大体积约10.5cm×5.2cm×4.0cm,均为食管壁内型和纵隔型。87例患者中在全电视胸腔镜辅助下行食管平滑肌瘤摘除术80例;另7例术中采用辅助小切口完成手术。结果术后所有患者均恢复顺利,无死亡及其他严重并发症发生。术后第1d进流质食物,术后第3d进普通食物。术后病理检查:均为食管平滑肌瘤。随访81例,随访时间6个月～6.5年,平均3.8年,食管平滑肌瘤无复发。结论电视胸腔镜辅助下行食管平滑肌瘤摘除术是食管平滑肌瘤首选的治疗方法,对食管平滑肌瘤直径>1.0cm者,应积极在电视胸腔镜下手术摘除。
Objective To investigate the value of video-assisted thoracoscopic surgery in the treatment of patients with esophageal leiomyoma. Methods The clinical data of 87 patients with esophageal leiomyoma treated with video-assisted thoracoscopic esophageal leiomyomactomy from June 2002 to January 2009 in Changhai Hospital affiliated to Second Military Medical University were retrospectively analyzed. There were 61 males and 26 females Cases; age 20 to 65 years, mean age 38.2 years old. 66 cases of middle esophageal leiomyoma, the lower 9 cases, the upper 12 cases. The smallest tumor diameter of about 0.5cm, the maximum size of about 10.5cm × 5.2cm × 4.0cm, are esophageal wall type and mediastinal type. Eighty-seven patients underwent esophageal leiomyoma resection with the aid of a video-assisted thoracoscopy in 80 cases. The other seven patients were assisted by a small incision to complete the operation. Results All patients recovered smoothly without death and other serious complications. 1d after surgery into the liquid food, into the first three days after the ordinary food. Postoperative pathological examination: all esophageal leiomyoma. Follow-up 81 cases, follow-up time of 6 months to 6.5 years, an average of 3.8 years, no recurrence of esophageal leiomyoma. Conclusion Video-assisted thoracoscopic assisted esophageal leiomyoma removal is the preferred treatment for esophageal leiomyoma. For patients with esophageal leiomyoma of diameter> 1.0cm, they should be actively removed by video-assisted thoracoscopic surgery.