先关胸左颈胸二切口行中上段食管癌切除术

目的提高食管癌手术疗效,降低术后并发症,改进胸中上段食管癌的手术方法。方法采用先关胸的左颈左胸二切口手术方法治疗中上段食管癌132例,即先开左胸游离胸段食管,并经膈肌游离胃,胃与食管临时连接后关胸,重摆平卧位,于颈部行食管胃吻合术。结果总并发症发生率为8.3%;吻合口漏1例,保守治疗治愈;无手术死亡。1、3、5年生存率分别为92.7%、65.3%、39.5%。结论改进的术式具有安全、快捷、有效、并发症少的优点。

Improved excision for esophagus carcinoma in thoracic middle-superior segment

Objective In order to obtain a better therapeutic effect and reduce postoperative complications,esophagectomy was improved.Methods The132cases with esophageal carcinoma in thoracic middle-superior segment were treated via closed thorax left cervical-left thoracotomy with two incision opening,i.e.the esophagus segment within thorax was freed through left thoracotomy firstly,the stomach through diaphragm hiatus,then the thoracic incision was closed after the stomach and the esophagus was temporarily connected with each other.Positioned the patient lie on his back and the esophagostroanastomosis was finished at last.Results The complication occurance was8.3%(11/132)totally.One case of anastomotic leakage happened and healed by conservative treatment.There is no perioperative death.The survival rate of1,3and5years were92.7%,65.3%and39.5%respectively.Conclusion The improved method is safe,time-saving,effective and less complication-occuring.