Title

Esophagectomies for Esophageal Cancer: Video-Assisted Thoracoscopic Surgery (VATS) Versus a Traditional Thoracotomy

Translated Titles

以視訊輔助胸腔鏡手術或傳統開胸手術進行食道癌之食道切除術之比較

Authors

顏銘宏(Ming-Hong Yen);洪士涵(Shih-Han Hung);黃清水(Ching-Shui Huang);劉榮森(Jung-Sen Liu)

Key Words

影像輔助胸腔鏡手術 ; 開胸手術 ; 食道癌 ; VATS ; thoracotomy ; esophageal cancer

PublicationName

輔仁醫學期刊

Volume or Term/Year and Month of Publication

9卷1期(2011 / 03 / 31)

Page #

23 - 29

Content Language

英文

Chinese Abstract

目的:傳統食道切除手術以經由開胸手術完成。而近年來,越來越多的外科醫師以微創食道切除手術來治療食道癌。在過去三年內,本院共有49名食道癌患者接受開胸或胸腔鏡手術治療。經由回顧病歷及資料分析,比較這兩組病人的差異。方法:共有49位食道鱗狀上皮細胞癌病患。手術皆以全身麻醉進行。開胸手術組全部接受右側標準後側開胸手術。胸腔鏡手術組由右側胸壁以四個套管進行。胸腔部分由胸腔外科醫師執行。腹部手術以正中開腹手術由一般外科醫師執行。結果:共有33位病患接受開胸手術,16位接受胸腔鏡手術。在手術時間、出血量及移除之淋巴節數目上兩組並無差異。胸腔鏡手術組之T期別較開胸手術組早(較多T2 且較少T3)。在呼吸器使用時間、住加護病房時間及住院天數方面,胸腔鏡手術組明顯比開胸手術組短,並且術後疼痛也較少。結論:胸腔鏡食道切除手術在治療可切除之食道癌上與開胸食道切除手術一樣有效,並且有較短的呼吸器使用時間、住加護病房時間及住院天數,術後疼痛也較少。( 輔仁醫學期刊2011;9(1):23-29)

English Abstract

Background and Purpose:An esophagectomy has traditionally been performed via a thoracotomy. In recent years, increasing numbers of surgeons are using a minimally invasiveesophagectomy for esophageal cancers. During the past 3 years, we treated 49 esophageal cancers by a thoracotomy or video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the medical records for data analysis and outcome assessment of these 2 groups. Materials andMethods:In total, 49 patients with esophageal squamous cell carcinomas were enrolled in thestudy. All operations were carried out under general anesthesia. All of the thoracotomy groupunderwent a right-side standard posterolateral thoracotomy. All of the VATS group received4 ports in the right-side chest. Thoracic procedures were performed by a thoracic surgeon.All abdominal procedures used an upper midline laparotomy by a general surgeon. Medicalrecords were retrospectively reviewed for data collection and analysis. Results:There were 33thoracotomies and 16 VATSs. There were no differences in operative time, blood loss, or numbers of removed lymph nodes between the 2 groups. The VATS group had less-advanced T stage (more T2 and fewer T3 cases) than the thoracotomy group. There were signifi cant differences in lengthsof ventilator use, intensive care unit stay, hospital stay and postoperative pain. Conclusions:A VATS esophagectomy was as effective as a thoracotomic esophagectomy in treating resectable esophageal cancers. Signifi cant advantages of VATS were observed in shortening the length of ventilator use, ICU stay, hospital stay, and postoperative pain. (FJJM 2011; 9 (1): 23-29)

Topic Category 醫藥衛生 > 醫藥衛生綜合