Techniques of uniportal video-assisted thoracic surgery-esophageal and mediastinal indications
Techniques of uniportal video-assisted thoracic surgery-esophageal and mediastinal indications
复制标题
DOI：
10.21037/jtd.2019.09.55
复制
发表时间：
2019-09-01
影响因子：
2.5
通讯作者：
Batirel, Hasau F.
中科院分区：
文献类型：
--
作者：
Batirel, Hasau F.
食管和纵隔的单门入路越来越受欢迎。虽然经胸入路通常从腋后线上的第5或第6肋间隙应用于食管，但通过右/左胸、颈部和剑突下区域进入前纵隔的入路是可变的。在出血、肿瘤学充分性和手术时间方面，单孔食管和纵隔手术的结果与多孔电视胸腔镜手术（VATS）和开放手术的结果相当。开放式和多入口VATS病例的适应症相似，但是，就手术的肿瘤学充分性而言，大型纵隔肿瘤（>5 cm）和T3-4食管癌在开始时可能具有挑战性。经食管和纵隔的单切口手术应用越来越多，初步报道表明其可行性，其适用性和优势将在未来几年内显现出来。
Uniportal approach for esophagus and mediastinum is gaining popularity. While a transthoracic approach is applied for esophagus frequently from the 5th or 6th intercostal space on the posterior axillary line, approach to anterior mediastinum is variable with access through right/left chest, cervical and subxiphoid regions. The results of uniportal approach for esophagus and mediastinum are comparable with multiport video-assisted thoracic surgery (VATS) and open approach in terms of bleeding, oncologic adequacy and operation times. Indications are similar with open and multiportal VATS cases, however large mediastinal tumors (>5 cm) and T3-4 esophageal cancers can be challenging in the beginning in terms of oncologic adequacy of the operations. Uniportal approach for esophagus and mediastinum is utilized more frequently and initial reports show that it is feasible and its applicability and advantages will become apparent in the coming years.