目的探讨食管多源癌的诊断及治疗方法。 方法回顾性分析2008年3月至2009年11月在四川大学华西医院行手术治疗的15例食管多源癌患者的临床资料，其中男14例，女1例，中位年龄62.5（48～75）岁。15例行手术治疗食管多源癌的患者中，行Sweet术式8例，左胸-左颈两切口4例，胸腹腔镜联合McKeown术式2例，开胸探查而未能切除肿瘤1例。 结果术前确诊11例，术前确诊率为73.3%（11/15）。术后1例发生肺部并发症，3例发生吻合口瘘，围术期无死亡。除肿瘤未能切除的患者外，随访13例，随访5年，1年生存率61.5%（8/13）、3年生存率30.8%（4/13）、5年生存率15.4%（2/13）。第一病灶位置与预后关系密切，第一病灶位于胸上段的食管多源癌患者，其中5例顺利完成手术，吻合部位均在颈部，2例食管残端存在癌残留（R1），1年内死亡3例，无1例获得3年生存。第一病灶位于胸中、下段的9例食管多源癌患者均完成根治性切除，食管及胃残端均无癌残留（R0），1年生存率75.0%，3年生存率50.0%，2例获得5年长期生存。 结论对于食管多源癌，如第一病灶位于胸中、下段，首选手术治疗。如第一病灶位于胸上段，不宜首选手术治疗，这类患者采用新辅助放化疗后再手术或直接采用其他治疗模式，这需要以后进一步研究比较。
ObjectiveTo evaluate clinical outcomes of single utility port video-assisted thoracoscopic surgery (VATS) lobectomy for patients with early-stage peripheral non-small cell lung cancer. MethodsWe retrospectively analyzed the clinical data of 46 consecutive patients with early-stage peripheral non-small cell lung cancer who underwent single utility port complete VATS lobectomy in the First Affiliated Hospital of Hebei north University from December 2012 through November 2014. There were 39 male patients and 7 female patients with their age of 42-76 (60.26±4.38) years (VATS group). There were 58 patients with early-stage peripheral non-small cell lung cancer who underwent lobectomy via traditional thoracotomy including 47 male and 11 female patients with their age of 44-73 (61.42±3.67) years for the same period (conventional thoracotomy group). Clinical outcomes were compared between the two groups. ResultsAll the operations were successful. There was no conversions during single utility port VATS lobectomy, and no periopera-tive death in both groups. The VATS group had significantly less blood loss (126.10±48.56 ml vs. 260.84±69.70 ml), and amount of thoracic drainage (230.52±50.22 ml vs. 380.16±96.24 ml, P<0.05). Hospital stay was significantly shorter in the VATS group than the conventional thoracotomy group (6.42±1.40 days vs. 9.64±2.08 days, P<0.05). However, there was no significant difference between the VATS group and the conventional thoracotomy group with regard to the opera-ting time (146.25±19.68 minutes vs. 139.26±25.39 minutes), number of lymph nodes procured (13.56±2.31 vs. 14.12±3.06), and postoperative complications (13.0% vs. 19.0%, P>0.05). ConclusionSingle utility port VATS lobectomy for patients with early-stage peripheral non-small cell lung cancer is technically feasible, with less blood loss and shorter hospital stays for achieving acceptable standards of lymph node dissection. It is a promising surgical procedures for patients with early-stage peripheral non-small cell lung cancer.