左胸左颈经食管床胃-食管颈部吻合术治疗食管癌

目的 探讨左胸左颈经食管床胃-食管颈部吻合术治疗食管癌的应用价值.方法 1997年12月～2005年11月,我们采用左胸左颈经食管床胃-食管颈部吻合术治疗食管癌46例,即常规游离正常及病变的食管,将胃经食管床、主动脉弓后上提至颈部行胃-食管吻合.结果 本组病例中,经手术治疗顺利康复出院40例,全组无手术近期死亡病例,切缘无癌残留.颈部吻合口瘘1例;呼吸道急性梗阻1例;术后呼吸衰竭应用呼吸机治疗1例;乳糜胸1例;排空障碍2例,经保守治疗痊愈.结论 左胸左颈经食管床胃-食管颈部吻合术治疗食管癌因游离胃位于主动脉弓后食管床内,故有主动脉弓的阻挡作用,在一定程度上可预防并降低术后返流性食管炎的发生,改善患者术后生活质量.避免在胸内吻合,防止了食管癌术后最严重的并发症-胸内吻合口瘘.因此,左胸左颈经食管床胃-食管颈部吻合的食管癌根治术是治疗食管癌的一种既安全又能提高生活质量的手术方式,有较高的应用价值.

Treatment of esophageal carcinoma with esophagogastroplasty through esophagus bed in left neck

Objective To explore the application value about treatment with carcinoma of esophagus esophagogastroplasty in left neck through esophagus bed. Methods From December 1997 to November 2005,46 patients with carcinoma of esophagus were treated in this way. Normal regulations visits were given to dissociate the normal and abnormal esophagus and esophagogastroplasty was performed. Results 40 patients were cured. No case died in the near future,and no cancer residues remained in the cutting edge. There was one case of fistula, 1 ease of acute obstruct of breathing tract, 1 case of respirator application because of respiratory failure, 1 case of chylothorax and 2 cases of empty dysfunction. Conclusion Since the dissociated stomach is located behind the aorta bow in the esophagus bed ,and the aorta bow has the countercheck function, the treatment can prevent the patients from developing the reflux esophagitis to a certain degree and improve the quality of life after the treatment. Anastomosis can be avoided in the chest,so the treatment can prevent patients from developing the most serious complications--esophageal fistula inside chest. Therefore,the esophagogastroplasty in left neck through esophagus bed as a treatment for carcinoma of esophgus is a kind of safe type. It can improve life quality. There is higher value of application.