左胸颈两切口食管癌切除术681例临床分析

为探讨左胸、颈两切口食管癌切除术的手术适应证、并发症的防治及术式的优点，回顾分析了681例左颈胸两切口食管癌切除术患者的临床资料。结果术后痊愈出院653例（95．89％）。术后病理确诊淋巴结转移327例（48．02％），分组标记证实颈、胸和腹3组淋巴结转移率分别为6．02％（41／681）、40．38％（275／681）和21.43％（146／681），残端癌发生率为1．32％（9／681），术后心电图异常者较术前增加明显。术后3、5年生存率分别为58．77％（345／587）和35．66％（184／516）。初步回顾性分析结果提示，左胸颈两切口食管癌切除术具有食管癌病灶切除彻底，残端癌发生率低，可同时清除颈、胸和腹3组淋巴结，严重并发症少等优点。

Clinical analysis of 681 cases of esophageal carcinoma treated by dual-incision of left neck and chest

The objective of this study was to discuss the indication,prevention and treatment of complications and the advantage of the esophagectomy and esophagogastroanastomosis with stomach transplantation via esophagus bed by dual-incision of left neck and chest.The data of 681 cases of esophageal carcinoma treated by this procedare were analysed retrospectively.The success rate of this procedure was 95.89%,327 cases were proved with lymph node metastasis pathologically,and the gross rate of lymph node metastasis was 48.02%.The rates of 1ymph nodes metastasis in neck,chest and abdomen were 6.02%(41/681),40.38%(275/681),21.43%(146/681),respectively.The occurrence rate of residual carcinoma was 1.32%(9/681).The overall 3 year and 5 year survival rates were 58.77%(345/587) and 35.65%(184/516),respectively.In conclusion,this procedure can resecte esophagoscope thorughly with low incidence of residual carcinoma and small severe complications.