中上段食管癌行两种三切口术式的比较

目的通过对两种三切口食管癌切除术的开胸时间、手术时间及术后并发症的研究,探讨三切口食管癌切除术的最佳术式.方法63例中上段食管癌患者被随机分为两组实验组39例,先开胸充分游离食管后关胸,再开腹游离胃,将肿瘤及胃经食管床递至颈部,行食管、胃吻合术(简称为先关胸手术);对照组24例,于手术开始时开胸,至肿瘤及胃均递至颈部后开始关胸(简称为后关胸手术).结果两组手术时间无显著性差异,但开胸时间及术后并发症的发生率实验组均小于对照组(P＜0.05).结论先关胸手术明显优于后关胸手术,应当大力提倡.但术前一定要充分估计到腹腔病变的情况,亦应高度重视本术式可能发生的相关并发症.

Comparison between Two Different 3-Incision Treatments of Upper and Middle Esophageal Carcinomas

Objective:To identify the advantages and shortcomings of two different 3-inci-sion treatments of upper and middle esophageal carcinomas to improve the surgical effect and re-ducing postoperative complications.Methods:Sixty-three cases of upper and middle esophageal cancers were randomly divided into two groups:Group A(39cases):The thoracic incisions were closed immediately after the tumors were resected,and group B(24cases):The thoracic incisions were not closed until the tumors were resected through the neck incisions.The incidense of postoperative complications with the time of whole operation and thoracic surgery were compared.Results:We found that in group A,the time needed in whole operation was not significantly lengthened but the time in thoracic surgery was shortened and the postoperative complications were greatly reduced especially the cardiopulmonary complications.Conclusion:The results showed that to close the thoracic incision first is superior to the thoracic incision to be closed later.This method should be chosen but close attention should be paid for the possibility of complications resulted from this procedure.