Thoracoscopic Operation for Esophageal Atresia
Thoracoscopic Operation for Esophageal Atresia
复制标题
胸腔镜手术治疗食管闭锁
DOI：
10.1007/978-4-431-55876-7_17
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
T. Iwanaka
中科院分区：
文献类型：
--
作者：
Kyoichi Deie;T. Iwanaka
我们描述了C型食管闭锁的初次胸腔镜修复术。我们举例说明了一个新生儿，出生体重≥2000克谁没有严重的心脏畸形或呼吸系统并发症的程序。气管内插管在自主呼吸下进行。患者被置于近俯卧位，右侧略微抬高。外科医生和助手将摄像机支架放在患者右侧。第一端口插入肩胛下角尾侧的肋间隙中，并且在第一端口的左右两侧插入两个工作端口。在确定奇静脉和迷走神经后，解剖下囊并结扎瘘管。上囊充分活动后，切除其远端。将锚定缝合线放置在上袋的后壁上，以将其锚在上袋的尾侧上。使用5-0号可吸收缝线进行吻合。在吻合后壁后，将经吻合鼻胃管插入食管下部。完成吻合后，通过摄像机端口插入胸腔引流管。胸腔镜下食管闭锁修补术的术后处理与传统开胸手术相似。
We describe primary thoracoscopic repair of type C esophageal atresia. We illustrate the procedure performed in a neonate whose birth weight was ≥2000 g who had no severe cardiac anomalies or respiratory complications. Intratracheal intubation is performed under spontaneous breathing. The patient is placed in a near-prone position with the right side slightly elevated. The surgeon and the assistant hold the camera stand on the right side of the patient. The first port is inserted into the intercostal space on the caudal side of the angulus inferior scapulae, and two working ports are inserted on the right and left sides of the first port. After identifying the azygos vein and the vagus nerve, the lower pouch is dissected and the fistula is ligated. After the upper pouch is adequately mobilized, its distal tip is resected. An anchoring suture is placed on the back wall of the upper pouch to anchor it on the caudal side of the upper pouch. Anastomosis is performed using 5-0 absorbable sutures. After anastomosis of the back wall, a transanastomotic nasogastric tube is inserted into the lower esophagus. After completing anastomosis, a chest drain is inserted through the camera port. The postoperative management after thoracoscopic repair of esophageal atresia is similar to that after conventional thoracotomy.