微创McKeown食管癌手术中气管免牵拉优先处理左喉返神经旁淋巴结的经验分享

Experience sharing of clearing the leftrecurrent laryngeal nerve lymph nodeas priority without tracheal traction in minimally invasive McKeown esophagectomy

YangGenrong，WangHan，ZhaoMingli

Department of Thracic Surgery，theFirst Hospital of Henan University of Traditional Chinese Medicine，

Zhengzhou 450000， China

【Abstract】ObjectiveTo summarize the experience of clearing the left recurrent laryngeal nerve lymph nodeas priority without tracheal traction in minimall invasive McKeown esophagectomy.MethodsA total of12 cases of minimally invasive McKeown esophagectomy from Sep 2023 to Sep 2O24 were selectedand the left recurrent laryngeal nerve （RLN） lymph nodes were removed preferentiallywithout tracheal traction.ResultsAll the operations on chest were successully completed without serious bleeding or other complications.It took （12.8± 3.7）min tocleartheleftrecurrntlaryngealnerve.The timeof chestoperation isabout （63.8±7.3）min，bleeding （47.0±17.3）ml，there were （3.1±0.9）left recurrent laryngeal nerve lymph nodes wereremoved.Hoarseness occurred in1 caseand recovered after 5 weeks，postoperative pulmonary infection occurred in1 case.Conclusion Clearingtheleftrecurrentlaryngeal nervelymph nodesaspriority treatment issafeand feasibleinminimally invasive McKeown esophagectomy.Itcanavoid theviolent injury tothe tracheaand isworthyofclinical promotion.

【Key words】 Esophageal neoplasms; Recurrent larynageal nerve; Lymph node excisionDOI：10.19522/j.cnki.1671-5098.2025.02.019

微创McKeown食管癌根治术是目前治疗食管癌的主要方式之一，具有创伤小、恢复快、疼痛轻等优点，被越来越多的胸外科医生所广泛开展，喉返神经旁淋巴结清扫在食管癌根治术中意义重大，可以显著提高患者的术后生存率，但术中喉返神经旁淋巴结的清扫难度较大，这主要是因为上纵隔空间狭小、难以显露，尤其是左喉返神经旁淋巴结的清扫，暴露不清或操作不当极易引起神经损伤，甚至导致严重的术后并发症[2]。（剩余4536字）