食管癌贲门癌术式与术后并发症的相关分析

目的：回顾性总结手术切除的1179例食管癌贲门癌病例,对手术方式和术后并发症的相关性做比较。方法：采用4种开胸入路手术方式。结果：1）右胸腹颈三切口手术157例发生并发症多。2）左胸颈二切口全胃食管床内移植123例,手术简便安全,并发症少。3）左胸主动脉弓上吻合215例,并发症最多。4）左胸主动脉弓下吻合684例,手术简单安全,并发症最少。结论：推荐食管上段癌手术选择右胸腹颈三切口术式,中段癌选左胸颈二切口,下段癌选择主动脉弓下吻合或左颈吻合,尽量少用主动脉弓上吻合。

Correlation Analysis of Postoperative Complications vs Operative Modality of Esophageal or Cardiac Cancer

Objective:To study the correlation of different operative modality and compli-cations after resection of esophageal or cardiac cancers.Methods:Four operative modalities were performed in1179cases of esophageal or cardiac cancer.Results:1)One hundred and fifty-seven cases underwent right "Tri-incision operation"(thoraco-abdominal and cervical inci-sions)with more complications.2)Left"Bi-incision operation"(Thoraco-cervical incisions)which was simple,safe and with few complications was performed in123cases.3)Most complications were observed in the patients underwent left supra--thoracic aortic arch anastomosis.4)Left in-frathoracic aortic arch anastomosis which was safe,simple and with least complications was used in684patients.Conclusion:It is suggested that the"Tri-incision operation"might be used for upper esophageal cancer,"Bi-incision operation"for mid-esophageal cancer,.and infra-thoracic aortic arch anastomosis for lower esophageal cancer.The supra-aortic arch anastomosis should be selected as less as possible.