机器人手术系统辅助食管切除术左侧喉返神经旁淋巴结清扫策略和技术要点

Strategies and technical key points of lymph node dissection along the left recurrent laryngeal nerve in robot-assisted esophagectomy

  • 摘要: 食管切除和淋巴结清扫是食管癌治疗的基石,上纵隔淋巴结清扫对于食管癌精准分期和改善病人预后具有重要价值。左侧喉返神经旁淋巴结清扫是食管外科极具挑战的操作,其解剖边界和清扫范围尚无相关共识。近年来,随着腔镜技术尤其是机器人手术系统在食管切除术中的应用,上纵隔微解剖概念的引入,笔者团队提出左侧喉返神经旁淋巴结清扫边界,以实现精准、根治性、规范化清扫。笔者结合中心经验,对机器人手术系统辅助食管切除术左侧喉返神经旁淋巴结解剖边界、清扫范围和技巧进行深入阐述。

     

    Abstract: Esophagectomy and lymph node dissection are the cornerstones for the treatment of esophageal cancer. Upper mediastinal lymph node dissection is of great value for accurate staging and improving the prognosis of patients. Lymph node dissection along the left recurrent laryngeal nerve is the most challenging procedures in esophageal surgery, and there has been no relevant consensus on the scope and boundary of lymph node dissection. In recent years, with the application of endoscopic technology, especially robotic surgery system in esophagectomy, and the introduction of the concept of superior mediastinal microdissection, the authors have proposed the border of lymph node dissection along the left recurrent laryngeal nerve, so as to achieve precise, radical and standardized dissection. Combined with their own experiences, the authors elaborate on the anatomic boundary, extent and technique of lymph node dissection along the left recurrent laryngeal nerve.

     

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