右胸及上腹两切口食管癌切除术510例

目的]观察二切口术式行胸段食管癌切除的优点.方法]对510例胸段食管癌采用右胸后外切口及上腹切口径路行食管癌切除术,并与三切口、左胸后外切口的病例进行比较.结果]二切口术与另2组手术切除率分别为98%、80%及78%,手术并发症发生率3组分别为16.0%、21.0%及28.0%;切端癌发生率分别为1.18%、2.83%、10.00%,手术死亡率3组分别为2.16%、2.83%及4.00%.部分病例随访5年生存率3组分别为30.0%、27.4%及21.4%.结论]对食管中、下段癌二切口术具有术野暴露好,切除率高及清扫彻底等优势.

Right Thoracal and Upper Abdominal Double Incisions for Surgery of Esophageal Cancer in 510 Cases

To investigate the advantage of right thoracal and upper abdominal double incisions for surgery in thoracic esophageal cancer.Esophagectomy with posterolateral right thoracal and upper abdominal double incisions was performed in 510 cases with thoracic esophageal cancer,which was compared with three incisions surgery and single posteroexternal left thoracal incision surgery.In double incisions,three incisions and single incision groups,the radical resection rate was 98%,80%,78%;surgical complication rate,16.0%,21.0%,28.0%;surgical margin positive,1.18%,2.83%,10.00%;and surgical mortality,2.16%,2.83%,4.00% respectively.The 5-year survival rate in the followed-up patients was 30.0%,27.4% and 21.4% respectively in the three groups.Conclusions]The double incisions surgery has advantages of excellent exposure,high resection rate, and complete lymph node dissection etc for middle or lower thoracic esophageal cancer.