经右胸中上段食管癌切除两种术式比较

目的：探讨右后外侧剖胸切除胸中上段食管癌两种术式的优缺点。方法：全组手术切除50例，分为AB两组。A组为先开腹再行右后外侧开胸术式组25例，B组为先开胸后行颈腹三切口术式组25例。结果：切除率100％，全部治愈出院。术后并发症：先开腹组发生心肺并发症4例，声嘶2例，颈部吻合口漏2例；先开胸组发生心肺并发症3例，胃排空障碍2例，声嘶1例。结论：在胸中上段食管癌切除术中，采用先开腹再行右后外侧开胸术式具有较多优点和灵活性，对较早期及切除把握较大的病人，推荐行先开腹术式。

Comparison between Two Methods of Resection of The Upper and Middle Esophageal Carcinoma Through Right Thorax

Objective: To evaluate two different methods of resecting the upper and middle esophageal carcinoma by righ-posterolateral thoracotomy. Methods: 50 cases were divided into two groups. 25 cases in group A were perfomed with the laparotomy before the thoracotomy, and 25 cases in group B were perfomed with the laparotomy and neck incision after the thoracotomy. Results; The rate of resection in the 2 groups were both 100 % . All the patients were cured. In group A, 4 cases of cardiac pulmonary complication, 2 cases of hoarseness and 2 cases of leakage of anastomosis in neck occured after operation. In groupB 3 cases of cardiac pulmonry complication, 2 cases of thoracic stomach draining obstruction and 1 case of hoarseness had occared after-operation.Conclusion: For treating the upper and middle esophageal carcinoma , the method of laparotomy following righ-posterolateral thoracotomy is superior. It should be recommended to the patients who were in early stage or evaluated cna be resected before operation.