青年医师连续52例食管癌、贲门癌手术无并发症治疗体会

目的总结青年医师连续食管癌、贲门癌手术无并发症的治疗体会。方法回顾性分析52例食管癌、贲门癌手术的临床资料,其中食管癌36例,贲门癌16例。肿瘤根治性切除后行食管胃胸膜顶吻合2例,主动脉弓上(含弓后)吻合13例,食管胃主动脉弓下吻合37例。手术均采用机械吻合。结果本组病例手术时间为160～280 min,围术期无麻醉意外,术中无大出血,无近期的吻合口狭窄,连续无吻合口瘘、脓胸、乳糜胸、心脑血管意外及肺部感染等并发症,均治愈出院。结论青年医师连续食管癌、贲门癌手术无并发症的关键在于"慎于术前,精于术中,勤于术后",多学习,并按照从贲门癌→食管下段癌→食管中段癌→食管上段癌这一由易到难的顺序进行。

A Yonng Doctor's Experiences of Complication-free Surgery in 52 Consecutive Cases of Esophageal and Cardiac Cancer

Objective To summarize the young surgeon’s experiences in continuous surgery of esophageal and cardiac cancer without complication.Methods A retrospective clinical analysis was done in 36 cases of esophageal cancer and 16 cases of cardiac carcinoma.After the radical resection of tumor,the esophagogastric anastomosis was undergone in 2 cases at the cervical pleura,13 cases above the aortic arch,and 37 cases below the aortic arch.Operations were all made by mechanical anastomosis.Results The operative time was 160~280min.There was no perioperative anesthesia accident,no bleeding during surgery,no anastomotic stenosis,no anastomotic fistula,no empyema,no chylothorax,no cardio-cerebro-vascular accident,nor lung infections.Conclusion It is the key to the young doctors in complication-free continuous operation for esophageal and cardiac carcinoma of " careful in preoperation,specializing in intraoperation and hard in postoperation".