516例颈段和胸上段食管癌外科治疗的临床分析

目的总结516例颈段、胸上段食管癌的外科治疗经验.方法对516例颈段、胸上段食管癌进行回顾分析.结果本组手术切除率90.9%,并发症发生率11.2%,手术死亡率1.5%.T分期高是影响手术切除的重要因素,术前放疗可减低T分期;术前CT、MRI、纤支镜检查可降低手术探查率,选择正确的手术径路可提高手术安全性.结论手术是治疗颈段、胸上段食管癌的重要手段之一.

Evaluation of esophagectomy in 516 cases of cervical and upper thoracic esophageal carcinoma

Objective To summarize the experience of esophagectomy in 516 cases of cervical and upper thoracic esophageal carcinoma.Methods 516 cases of cervical and upper thoracic esophageal carcinoma underwent esophagectomy and 49 cases underwent surgical excision.Of them,455 underwent gastric transposition,14 colon interposition.Left neck and left-posterolateral approaches were unedin 342 cases,right-neck,right-posterolateral and laparotomical approaches were used in 78 cases,and left-neck and laparotomical approaches were usedin 22 cases.Results Surgical resection rate was 90.9%.Morbidity and mortality rates were 11.2% and 1.5,respectively.Conclusion Surgical resection is the important way in the treatment of cervical and upper thoracic esophageal carcinoma.Tumor stage is the key factor determining surgical resection.Preoperative radiotherapy can lower tumor stage,pre-operative CT,MRI and fibrebronchoscopic examinations decrease exploration rate.Correct surgical approach improves the safety of operation.