食管全切除、胃代食管颈部吻合治疗食管癌125例报告

１９７５年９月至１９９４年４月行食管癌切除３９７例，其中１２５例行食管全切除、胃代食管颈部吻合．食管全切除，肿瘤切除彻底，切缘残留癌发生率为０．８％，明显低于食管部分切除、食管胃胸内吻合残留癌的发生率（４．８％）．颈部吻合口瘘发生率较高，但伤口容易引流，预后较好，其死亡率为９．１％，明显低于胸内吻合口瘘的死亡率（５０．０％）．作者对胃代食管方法加以改进，使胃完全纳入原食管床内，既有利于吻合口的愈合，又减少了对心肺功能的影响，取得了满意的效果．

Subtotal Esophagus Resection for Carcinoma with an Experience of 125 Cases

From September 1975 to April 1994 , esophagus resection was performed on 397 patients with carcinoma, among whom, subtotal esophagus resection with cervical anastomosis was done in 125 patients. Subtotal esophagus resection can radically removed carcinoma with a lower stump residue incidence of 0.8%,as compared with that of 4.8% for esophagus resection with anastomosis in the chest. Although cervical anastomosis leakage is common, the management of such complication is relatively easy with a mortality of 9.1%,which was significantly lower than that of anastomosis fistula in the chest(50.0%). The author modified the operation by passing the stomach through the esophageal bed in the posterior mediastinum. Such modification is good for anastomosis healing, and avoids postoperative cardiopulmonary complications.