微创食管切除术治疗食管癌

F. Berlth, E. Hadzijusufovic, C. Mann, U. Fetzner, P. Grimminger
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引用次数: 2

摘要

微创食管切除术治疗食管癌肿瘤性食管切除术加胃上拉胸内切除术是食道及食管胃交界恶性肿瘤根治性治疗的标准手术方法。由于该手术需要进入两到三个体腔,因此具有自然的侵入性,这表明使用微创手术(MIS)可以降低手术创伤。由于手术过程的复杂性,微创食管切除术是一项具有相关手术学习曲线的手术。到目前为止,两种主要不同的微创食管切除术技术已在专业中心的临床常规中建立,即传统的基于腹腔镜/胸腔镜的方法和机器人方法。微创食管切除术的好处是减少肺部并发症和术后疼痛。两种微创技术的手术根治性至少与开放入路和MIS/开放联合入路相当,随机对照试验的长期生存结果尚待确定。机器人手术技术在过去十年中有了巨大的发展,肿瘤食管切除术提供了有意义的应用机会。由于进一步的技术进步,机器人手术有望在未来发挥更重要的作用。针对传统微创食管切除术与机器人辅助食管切除术的直接比较,随机化的ROBOT-2试验将提供重要的证据。
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[Minimally Invasive Esophagectomy for Esophageal Cancer].
Minimally Invasive Esophagectomy for Esophageal Cancer Abstract. Oncological esophagectomy with gastric pull up and intrathoracic represents the standard surgical procedure in the curative treatment of malignant tumors of the esophagus and the esophagogastric junction. The procedure, as two or three body cavities are accessed, has a natural level of invasiveness, which suggests lowering the surgical trauma using minimally invasive surgery (MIS). Because of the complexity of the surgical procedure, minimally invasive esophagectomy is an operation with relevant surgical learning curve. As of now, two principally different minimally invasive techniques for esophageal resection are established in clinical routine in specialized centers, the conventional laparoscopy/thoracoscopy based method and the robotic approach. Benefits of minimally invasive esophagectomy are reduced pulmonary complications and reduced postoperative pain. The surgical radicality of both minimally invasive techniques is at least comparable to the open approach and combined MIS/open approach, long-term survival outcomes from randomized controlled trials are pending. The robotic surgical technology has evolved dramatically over the last decade and oncological esophagectomy offers meaningful opportunity for application. Due to further technological progress, robotic surgery is expected to play an even more important role in the future. Focusing on the direct comparison of conventional minimally invasive esophagectomy and robotic-assisted esophagectomy, the randomized ROBOT-2 trial will reveal important evidence.
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[ANCA-Associated Vasculitides]. [Chronic Periaortitis]. Einleitung Vaskulitis [Update Esophageal Diverticula]. [State of the Art Diagnostics of the Esophagus].
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