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首页> 外文期刊>Surgical Endoscopy >Laparoscopically assisted transhiatal resection for malignancies of the distal esophagus.
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Laparoscopically assisted transhiatal resection for malignancies of the distal esophagus.

机译：腹腔镜辅助的经食管切除术治疗远端食管恶性肿瘤。

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BACKGROUND: Resection of the esophagus remains the only curative therapy for esophageal cancer. Conventional resections are right-side thoracotomy in combination with laparotomy, gastric tube creation, and the transhiatal approach according to Orringer. This study evaluated laparoscopically assisted transhiatal esophagus resection, which offers perfect visualization of the esophagus during mediastinal dissection without the necessity of a thoracotomy. METHODS: In this study, 25 laparoscopically assisted transhiatal esophagus resections were compared with a historical control group consisting of 20 open transhiatal esophagus resections. RESULTS: Nine laparoscopically assisted resections (36%) were converted to open procedures. The operating time was longer in the laparoscopically assisted group (300 vs 257 min; p < 0.05), but laparoscopically assisted esophagus resection was associated with less blood loss (600 vs 900 ml; p < 0.05) and shorter intensive care unit stay (1 vs 2 days; p < 0.05). There were no differences in morbidity, mortality, and hospital stay. During a shorter follow-up time for the laparoscopic group (17 vs 54 months), 11 patients (44%) in the laparoscopically assisted group and 10 (50%) patients in the open group had recurrence of the disease. CONCLUSIONS: Laparoscopically assisted transhiatal esophagus resection is a safe procedure with important advantages, as compared with the open procedure, such as less blood loss and shorter intensive care unit stay. At this point, the oncologic consequences are not clear.
机译：背景：食管切除术仍然是食道癌的唯一治疗方法。根据Orringer的说法，传统的切除术是右侧开胸结合剖腹术，胃管成形术和经食管入路。这项研究评估了腹腔镜辅助的经食管穿刺食道切除术，它可以在纵隔清扫过程中提供食道的完美可视化，而无需进行开胸手术。方法：在本研究中，将25例腹腔镜辅助的经食管穿刺食管切除术与一个历史对照组进行比较，该对照组由20例经口的经食管穿刺食管切除术组成。结果：九例腹腔镜辅助切除术（36％）被转换为开放手术。腹腔镜辅助组的手术时间更长（300 vs 257 min; p <0.05），但腹腔镜辅助食管切除术的失血量较少（600 vs 900 ml; p <0.05），重症监护病房住院时间较短（1） vs 2天; p <0.05）。发病率，死亡率和住院时间均无差异。在腹腔镜组较短的随访时间内（17个月对54个月），腹腔镜辅助组的11例患者（44％）和开放组的10例（50％）患者已复发。结论：与开放手术相比，腹腔镜辅助经食管食管食管切除术是一种安全的方法，具有重要的优势，例如失血少，重症监护病房住院时间短。在这一点上，肿瘤的后果尚不清楚。

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