上段食管癌的非开胸切除

目的探讨上段食管癌的手术治疗术式和操作要点。方法回顾分析了我科1996年4月至2002年12月收治上段食管癌74例患者，肿瘤下缘均在主动脉弓上缘以上，采用非开胸切除，胃或结肠代食管颈部吻合。结果74例均顺利完成手术，32例上胸骨劈开，全喉全食管切除5例，结肠代食管6例，吻合口瘘5例．肺部感染2例，喉返神经损伤2例，胃排空障碍1例，呼吸衰竭死亡1例。结论本报告方法避免开胸、创伤小，操作方便且效果满意。

No-thoracotomy of upper esophagus carcinoma

Objective To evaluate the surgical procedure for the treatment and main points of the procedure of upper esophagus carcinoma.Methods 74 patients with upper esophagus carcinoma who had received surgical treatment in our surgery department from April 1996 to December 2002 were reviewed retrospectively. The patients were enrolled in this study. The lower line of tumors were above the convexity of the aortic arch. We used the methods of no thoracotomy and anastomosed esophagus replaced with stomach or colon in cervical part. Results 74 patients had completed successfully. 32 patients splitted the superior sternum, 5 patients total laryngectomy and total esophagectomy, 6 patients esophagus replacement with colon, 5 patients anastomotic leakage, 2 patients pulmonary infection, 2 patients recurrent laryngeal nerve injuried, 1 patient gastric emptying difficultly, 1 patient died of respiratory failure. Conclusions The advantages of the surgical procedure are obvious; a thoracotomy is avoided, thus minimizing the physiological insult of the operation; its simplicity and satisfactory results, and its wide application seem justified.