电视胸腔镜手术治疗食管平滑肌瘤

目的探讨电视胸腔镜手术（video-assisted thoracoscopic surgery,VATS）治疗食管平滑肌瘤的应用价值。方法2000年7月-2007年10月应用VATS治疗食管平滑肌瘤19例,全身麻醉,侧卧位,根据食管肿瘤位置,选取3个1.5-2.0 cm胸壁切口,作为胸腔镜观察口及操作口,术中胃镜辅助操作。结果电视胸腔镜食管平滑肌瘤切除18例;1例术前诊断3cm×2 cm食管平滑肌溜,术中证实为巨大平滑肿瘤,中转开胸。术后恢复顺利,无手术死亡及严重并发症,术后病理诊断均为平滑肌瘤。19例随访5-35个月,平均24.5月,无复发。结论电视胸腔镜肌瘤切除术可作为食管平滑肌瘤的首选治疗方法,对于较大食管平滑肌瘤应考虑开胸手术。

Treatment of Esophageal Leiomyoma with Video-assisted Thoracoscope

Objective To discuss the value of video-assisted thoracoscope in the treatment of esophageal leiomyoma. Methods Clinical data of 19 patients with esophageal leiomyoma treated by video-assisted thoracoscopy from July 2000 to October 2007 were reviewed retrospectively. Under general anaesthesia with the patients at the lateral position according to the location of esophagcal leiomyoma,3 incisions were made on the chest wall for insertion of the trocars. Gastroscope was applied for intraoperative auxiliary operation. Results Under a video-assisted thoracoscope, enuclcation of the leiomyoma was performed on 18 of the patients, the other one, who were diagnosed with esophageal leiomyoma （3cm × 2 cm） was converted to thoracotomy because of the tumor was confirmed huge during the thoracoscopy. No postoperative death or severe complications occurred. Pathological examination confirmed the diagnosis of leiomyoma in all of the cases. The patients were followed up for a mean of 24.5 months （5 - 35 months） , no recurrence was found during the period. Conclusions Video-assisted thoracoscopy can be the first choice for the treatment of esophageal leiomyoma. Open surgery should be considered if the tumor is huge.