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胸部食道癌に対する根治切除術式における胸部操作を,開胸操作に替えて胸腔鏡下で行う術式を試みたので報告する,〈方法〉1994年9月から1995年9月までに,術前予想深達度m3以上A2以下を適応として,40例に施行した.〈結果〉胸腔内操作に要した時間は平均225分で,この部位の出血は270mlであった.開胸に移行した例はなく,21例が術後機械的呼吸補助を要さず,術後1か月目の肺活量は術前の83%で,以後は術前と同じレベルに回復する傾向があった.郭清リンパ節は胸部のみで20個,17例に転移を認めた.〈結論〉胸腔鏡下の食道切除術は,標準手術として有用であった.
We examined on the feasibility of the thoracoscopic esophagogastrectomy with mediastinal lymphade-nectomy. Materials & Methods : Since September 1994 until September 1995, 40 patients whose tumor were not invading surrounding organs had undergone the proce-dure. Six trocars were introduced into the right pleural cavity. Two stay-sutures were placed on mediastinal pleura and then each end was retracted through tho-racic cage to expose posterior mediastinum and to keep the right lung out of operating field. Esophageal dissec-tion and mediastinal lymphadenectomy were performed under observation through video monitors.
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