| 董祎楠,张 亮,孙 楠.T形吻合应用于全胸腹腔镜Ivor Lewis食管癌切除术的临床研究[J].中国肿瘤,2016,25(3):233-236. |
| T形吻合应用于全胸腹腔镜Ivor Lewis食管癌切除术的临床研究 |
| A Clinical Study of T Shaped Gastroesophageal Anastomosis for Totally Laparoscopic Thoracoscopic Ivor Lewis Esophagectomy for Esophageal Cancer |
| 投稿时间：2015-11-19 |
| DOI：10.11735/j.issn.1004-0242.2016.03.A015 |
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| 中文关键词: 全胸腹腔镜 T形吻合 胸内食管胃吻合 |
| 英文关键词:totally iaparoscopic thoracoscopic T shaped gastroesophageal anastomosis intrathoracic esophagogastral anastomotic |
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| 中文摘要: |
| 摘 要：［目的］ 评价全胸腹腔镜下Ivor Lewis食管癌切除术中直线吻合器吻合应用的价值。［方法］ 整个吻合过程借助腔镜下直线切割吻合器（强生Ethicon flex 60直线吻合器）完成。首先，以直线切割吻合器斜向上方击发建立胃食管的侧—侧吻合形成吻合口的上、下两壁，再次使用直线切割吻合器沿管状胃的延长线切割击发，完成吻合口的制作，同时切除胃小弯及食管肿瘤。当吻合完成后吻合口的平面呈矢状位，由上缘、下缘和前缘构成。［结果］ 2014年2月至2015年12月，共有28例患者接受这种吻合方式的Ivor Lewis食管癌切除术，最长随诊时间为22个月，最短1个月，无吻合口出血，无吻合口瘘及吻合口狭窄。［结论］ T形吻合应用于全胸腹腔镜Ivor Lewis食管癌切除术受空间制约小、操作过程简单、吻合可靠，是一种安全有效的全胸腔镜下胸腔内胃食管吻合方式。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the role of T shaped gastroesophageal anastomosis for totally laparoscopic thoracoscopic Ivor Lewis esophagectomy for esophageal cancer. ［Methods］ A new technique for the endoscopic gastroesophageal anastomosis was completed just with a linear stapler (Ethicon Flex 60). In this technique，a linear stapler was first fired upward to establish the side to side anastomosis of the esophagus and stomach. This created the anterior and posterior wall of the anasmotic site. The linear stapler was then fired along the extension line of the gastric conduit，to complete the anastomosis and at the same time resected the lesser curvature of the stomach and the esophageal cancer. Upon completion，the anastomotic plane was axial，and contained a superior edge，inferior edge，and anterior edge. ［Results］ From February 2014 to December 2015，28 esophageal cancer patients were performed the minimally invasive Ivor Lewis esophagectomy with this anastomosis. These patients were all followed up within 1~22 months. None of these patients had any anastomotic bleeding，leak，or stenosis. ［Conclusions］ This new technique is less restricted by the limited space during minimally invasive Ivor Lewis procedure. The anastomotic technique is easy to perform and appears to be reliable，safe and effective judging from our limited clinical experience up to this date. |
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