Coordination skills of the hand mirror in thoracoscopic esophagectomy for mediastinal lymph node dissection / 中国综合临床

ABSTRACT

Objective To explore the coordination skills of the assistant hand mirror in thoracoscopic esophagectomy for mediastinal lymph node dissection.Methods From September 2012 to September 2016,four hundred and thirty-eight cases were treated with thoracoscopic and laparoscopic esophagectomy for esophageal cancer in the Department of Cardiothoracic Surgery,Affiliated Hospital of Putian University.Retrospective analysis was made to summarize the matters needing attention in the mediastinal lymph node dissection of different regions.Results All the operations were successful,thirty-four cases were transferred to thoracotomy,and the conversion rate was 7.8％ (34/438).Twenty-three cases were converted to open surgery,and the conversion rate was 5.2％ (23/438).The operation time ranged from 186 to 358 min,with an average of (245.5±62.2) min;the intraoperative bleeding volume ranged from 50 to 1350 ml,with an average of (100±10) ml;the removal time of closed thoracic drainage tube ranged from 8 to 46 d,with an average of (12.4±3.5) d;and the hospitalization time ranged from 14 to 52 d,with an average of (17.9± 2.6) d.Conclusion In thoracoscopic mediastinal lymphadenectomy for esophageal cancer,the arm-rest needs to systematically understand the structure,performance and operation method of each component of thoracoscopy,fully grasp the operation procedure and corresponding anatomical structure of esophageal cancer,fully understand the operation habits of the operator,dynamically and timely adjust the angle and focal length of the lens,and match them.The operation was successfully completed.