Establishment of thoraco- and laparoscopic esophagactomy as a minimally invasive surgery

建立胸腔镜和腹腔镜食管切除术作为微创手术

• 批准号: 14571229
• 负责人: INOUE Haruhiro
• 金额: $ 1.79万
• 依托单位: Showa University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14571229/
• 关键词: minimally invasive surgery; Thoraco, laparoscopic surgery; esophageal cancer; HALS; Thoracosoopic surgery; Laparoscopic surgery; Ropeway technique; recurrent laryngeal nerve; 鏡視下食道切除再建術; 胸部食道癌

We endeavored to develop a minimally invasive surgery for esophageal cancer using thoraco- and laparoscopic approach.The first clinical case received this surgical procedure in June 2, 1997. Ten years have passed after that surgery, and now he is doing well with no recurrence of esophageal cancer. Our surgical procedure is a combination of HALS (hand-assisted laparoscopic surgery) procedure and VATS (video-assisted thoracoscopic surgery). In the initial phase of the surgery, cervical area and abdominal areas are firstly approached. Using HALS technique, whole stomach is fully mobilized and then gastric tube is designed. Transphrenic dissection of lower esophagus is done by laparoscopic approach. Bilateral cervical dissection is performed from neck surgical wound. In the cervical operative field, bilateral recurrent laryngeal nerves are taped by vascular tape which is utilized for safe and effective management of lymph node dissection along the recurrent laryngeal nerves at the thoracoscopic phase. We call this technique as "ropeway technique".So far, 120 cases received this procedure as a surgery for esophageal cancer. One month operative death was one (0.8%). In that case the major cause of death was renal failure with no major surgical trouble. Crude overall five year survival rate including other causes of death was 56%. Mean operating time was less than 6 hours.We believe that the techniques of thoraco- and laparoscopic surgery for the esophagus have been established. In the future further improvement of the surgical techniques is expected as a more minimally invasive treatment.

我们致力于开发胸腔镜和腹腔镜食管癌微创手术。1997年6月2日，第一例临床患者接受了这种手术。手术后十年过去了，现在他的情况很好，没有复发。食道癌。我们的手术结合了 HALS（手助腹腔镜手术）和 VATS（电视辅助胸腔镜手术）。在手术的初始阶段，首先接近颈部区域和腹部区域。利用HALS技术，将整个胃充分动员起来，然后设计胃管。下食管的经膈解剖是通过腹腔镜方法完成的。从颈部手术伤口处进行双侧颈椎解剖。在颈部手术区域，用血管胶带绑扎双侧喉返神经，用于胸腔镜阶段沿喉返神经安全有效的淋巴结清扫。我们称这种技术为“索道技术”。迄今为止，已有120例食管癌手术接受了这种手术。 1 个月手术死亡人数为 1 人（0.8%）。在该病例中，死亡的主要原因是肾衰竭，没有重大手术麻烦。包括其他死亡原因在内的总体五年粗生存率为 56%。平均手术时间不到6小时。我们相信胸腔镜和腹腔镜食管手术的技术已经建立。未来，预计手术技术将进一步改进，成为更微创的治疗方法。

项目成果

Development of Virtual Histrogyand Virtual Biopsy Using Laser-scanning Confocal Microscopy

使用激光扫描共焦显微镜进行虚拟组织学和虚拟活检的开发

• 发表时间: 2003
• 期刊: Scandinavian Journal of Gastroenterology 38
• 作者: Inouem H.;J.-Y. Cho
• 通讯作者: J.-Y. Cho

Endoscopic Mucosal Resection in the Esophagus

内镜食管粘膜切除术

• 发表时间: 2003
• 期刊: Laparoscopic Surgery of the Abdomen 1
• 作者: Inoue H.;Kudo S
• 通讯作者: Kudo S

Kumagai Y, Fukami N, Inoue H: "Dynamism of tumour vasculature in the early phase of cancer progression : outcomes from oesophageal cancer research"THE LANCET Oncology. 3. 604-609 (2002)

Kumagai Y、Fukami N、Inoue H：“癌症进展早期阶段肿瘤脉管系统的动态：食道癌研究的结果”《柳叶刀肿瘤学》。

Inoue H, Fukami N, Yoshida T, et al.: "Endoscopic mucosal resection for esophageal and gastric cancers"J Gastroenterol and Hepatol. 17. 382-388 (2002)

Inoue H、Fukami N、Yoshida T 等人：“食管癌和胃癌的内镜粘膜切除术”J Gastroenterol and Hepatol。

Roy MS, Friedland S, Chang K, Inoue H: "Endoscopic mucosal resection -application in the upper gastrointestinal tract"Practical gastroenterology. 66-74 (2002)

Roy MS、Friedland S、Chang K、Inoue H：“内镜下粘膜切除术 - 在上消化道中的应用”实用胃肠病学。