胸腹腔镜联合胃镜、超声胃镜微创治疗巨大上消化道良性肿瘤屠惠明费.docVIP

胸腹腔镜联合胃镜、超声胃镜微创治疗巨大上消化道良性肿瘤 屠惠明 费伯建 翁鸢 许洪卫 许科斌 周洪伟 金留根 王卫理 许示心 乔峤李捷 钱荦荦 魏丽君 刘慧智 作者单位：苏州大学第四临床医学院、无锡市第四人民医院、无锡市肿瘤医院 邮编214062 【摘要】目的 探讨胸腔镜或腹腔镜联合胃镜、超声胃镜,微创手术治疗上消化道良性肿瘤方法的临床价值。方法：随访分析31例上消化道良性肿瘤病人的临床资料，26例病人经术中胃镜准确定位，超声胃镜确定病变的性质和深度，胸腔镜或腹腔镜行微创局部切除手术（EAWR）；5例病人由腹腔镜管腔外协助胃镜行内镜下粘膜切除术或粘膜剥离术（LAER）。结果：31例在双镜联合下成功施行微创局部切除术，手术时间EAWR58.5±13.9min，LAER32.4±5.3 min，术后住院EAWR7.3±1.87 d，LAER 5.2±1.3 d，随访0.5～5年，无复发等并发症。结论：通过胸、腹腔镜联合胃镜及超声胃镜微创手术治疗上消化道良性肿瘤，有利于腔镜下快速准确定位病变，有利于胃镜下巨大病变EMR\ESD的安全性，从而提高腔镜手术的成功率，是一种安全、有效的微创治疗方式，有一定的临床推广应用价值。 【关键词】上消化道良性肿瘤；微创手术；胸腔镜；腹腔镜；胃镜；超声内镜 Simultaneous Use of Thoracoscopy /Laparoscopy and gastroscopy / Ultrasonic gastroscopy for Minimally Invasive Resection of Upper Gastrointestinal benign tumor— Analysis of 31 Interventions TU Hui-min，CHEN Ping-kang,FEI Bai-jian，WEN Yan，XU Hong-wei ，XU Ke-bin，WANG Wei-li，XU Shi-xing，QIAO Qiao，JIN Liu-gen，LI Jie，QIAN Luo-luo，WEI Li-jun，LIU Hui-zhi,et al. Oncology Institute of Wuxi, the Fourth Affiliated Hospital of Soochow University, PR China　214062 【Abstract】Objective: To investigate the clinical values of thoracoscopy/ laparoscopy combined with gastroscopy/ultrasonic gastroscopy for treating upper gastrointestinal benign tumors.Methods:Clinicopathologic features and follow-up results of 31 consecutive patients undergoing a combined thoracoscopic- / laparoscopic- endoscopic approach for upper gastrointestinal tumors were prospectively analyzed. After localizing with gastroscopy and determining the property and depth, Twenty six tumors were locally resected in minimal invasion by thoracoscopy/ laparoscopy; other five tumors were done by endoscopic mucosal resection or endoscopic submucosal dissection with laparoscopically assisted endoscopic snare resection.Results: Upper gastrointestinal benign tumors in 31 cases were localizly resected under laparoscopy combined with gastroscopy successfully. Mean　operative time was EAWR58.5±13.9min，LAER32.4±5.3 min; and the postoperative hospitalization wasEAWR7.3±1.87 days，LAER 5.2±1.3 day