改良Ivor-Lewis术式在食管癌手术中的应用体会

目的　应用改良Ivor -Lewis术式治疗食管癌。方法　 1995年 2月至 1999年 9月我院对 86例食管癌病人应用右胸前外侧、上腹部正中切口切除胸段食管癌。同时采用机械方法经胸内进行食管、胃颈部吻合 (颈段食管胃吻合 )。结果　 86例中无手术死亡。无吻合口瘘、狭窄 ,无乳糜胸发生。 2例发生脓胸 ,经引流、抗感染治愈 ,1例病理检查切缘阳性 ,术后补充放疗。胃排空障碍 4例 ,经保守治愈。结论　改良Ivor-Lewis对食管中下段癌是较理想的术式。

The Application of Modified Ivor- Lewis Operation for Esophageal Cancer

Objective To treat esophageal cancer with modified Ivor-Lewis operation.Methods From February 1995 to September 1999,86 patients with esophageal cancer were operated on by right thorax and median abdominal incisions and esophagogastro anastomosis was performed on the neck using mechanical methods transthorax(cervical esophagogastro anastomosis).Results There were no operative death,anastomotic leakage stinosis and chylothorax.Two patients with pyothorax were cured by drainage and antiinfective therapy.One case with pathologically positive stamp received postoperative radiotherapy and four patients with delayed gastric emptying were cured by conservation therapy.Conclusions The modified lvor Lewis operation was the theoretical plate method to treat middle and low esophageal cancer.