46例食管癌患者的临床手术治疗探讨

目的分析食管癌的临床手术治疗方式与效果。方法本组研究对象为46例食管癌手术患者，病变位于食管上段12例，食管中段28例，食管下段6例；二切口手术21例，三切口25例。结果近期并发症发生率二切口组术后为9．5％，三切口组为36．0％，差异有显著性（P=0．030），两组均无术中死亡及住院死亡；二切口组术后1，3年生存率分别为84．2％和57．1％，三切口组分别为77．3％和50．0％。两组1，3年生存率比较无统计学差异（P〉0．05）。结论手术采用三切口与二切口具有各自的优点与适用范围，需根据病变的具体情况而定；无论二切口还是三切口，采用颈部吻合都是较好的选择。

Analysis of clinical operation of 46 cases of esophageal cancer

Objective To analyze the clinical operative measures and efficacy of esophageal cancer treatment. Methods Forty-six patients with esophageal cancer were chosen for the study. Of them 12 had lesions located in the upper esophagus, 28 located in the middle and 6 located in the lower esophagus. Operations of 21 cases used two incisions and 25 cases used three incisions. Results The incidence of postoperative complications in two incision group was 9. 5% and three incision group 36. 0%. The difference had significance （P = 0. 030）. Neither group had intraoperative death and in hospital death. The survival rate of two incision group after 1 and 3 years were 84. 2% and 57.1% respectively, while the three incision group 77. 3% and 50. 0%. The survival rates after 1 and 3 years of two groups had no statistical difference （ P 〉 0. 05）. Conclusion Three or two incisions in operation with their respective advantages and application area should be decided according to the specific circumstances of disease. Cervical anastomosis is a good choice whether two or three incisions are used.