ObjectiveTo evaluate the efficacy and safety of robot-assisted thoracoscopic esophagectomy in the treatment of esophageal carcinoma. MethodsWe retrospectively analyzed the clinical data of 79 patients with robotassisted thoracoscopic esophagectomy in our hospital from August 2010 to June 2015. There were 43 males and 36 females at average age of 62 years. The clinical effect was analyzed. ResultsThe mean operation time was 245 min (range 170 min to 330 min). The mean blood loss was 75 ml (range 20 ml to 310 ml). The mean hospital stay was 10.2 days (range 7 days to 26 days). Two perioperative deaths occurred. A total of 14 (17.7%) patients with complication were reported. Mean lymph node harvest was 20.7 nodes with 10.9 in chest, 9.6 in abdomen. ConclusionRobot-assisted thoracoscopic esophagectomy is technically feasible and safe. It is expected to reduce surgical trauma and reduce the incidence of pulmonary complications.
目的 探讨经右胸入路胸腔镜下胸导管结扎在乳糜胸治疗中的作用及优势。 方法 回顾性分析南京军区南京总医院心胸外科 2012～2014 年采用胸腔镜手术治疗乳糜胸 18 例患者的临床资料，男 15 例、女 3 例，年龄 56～79（66.56±6.43）岁。所有患者均采用右胸入路胸腔镜辅助下行胸导管结扎，术中若能找到明显破口，则在破口的两端用 Ham-lock 夹闭胸导管，若未能找到明确的胸导管破口，则在第 8、第 9 胸椎附近用 Ham-lock 将胸导管及周围脂肪组织一起夹闭。 结果 全组 18 例患者均完成手术，无中转开胸，手术时间 28～45（35.83±4.58）min，术后胸腔引流时间 2～5（3.33±1.03）d，术后住院时间 5～8（6.11±1.02）d。术后无感染、吻合口瘘等严重并发症，随访 3 个月无复发。 结论 经右胸入路胸腔镜辅助手术结扎胸导管治疗乳糜胸是一种安全、有效的治疗方法，因其微创、住院时间短、手术效果确切等优点，值得在临床上推广。
Objective To explore method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal gastric cancer (GC). Methods The clinical data of 30 patients with distal GC underwent the total laparoscopic radical gastrectomy from October 2017 to March 2018 in the Departmeng of Tumor Surgery, Lanzhou University Second Hospital were retrospectively analyzed, the total laparoscopic radical distal gastrectomy were performed in all the patients and the jejunum nutrition tube were implanted during the operation. Results Thirty patients with distal GC were successfully treated with the total laparoscopic radical gastrectomy and the jejunum nutrition tubes were implanted into under the total laparoscopy through the intraoperative guidance by the gastric tube, firstly fastening the nutrition tube to the gastric tube in vitro, and then separating them in vivo, finally the nutrition tube was smoothly implanted into the jejunum under the direct vision. The implantation time was 10 to 15 min with an average of 13.5 min. The jejunal nutrition tube retention time was 5 to 7 d with an average of 6 d. There were no complications such as the bleeding, anastomotic leakage, anastomotic obstruction, stenosis, intestinal leakage, intestinal obstruction, and other complications after the operation in the 30 patients. Conclusions Method of jejunum nutrition tube implantation in total laparoscopic radical gastrectomy for distal GC is easy to be performed. Intraoperative and postoperative complications are few. It provides a favorable guarantee for improving postoperative nutritional status of patient with distal GC.