经左胸左颈手术治疗食管上胸段癌

目的 :评价食管上胸段癌经左胸左颈治疗的益处及可行性。方法 :1999年 1月～ 2 0 0 1年 10月我院经左胸左颈手术治疗食管上胸段癌 2 8例 ,与同期经右胸腹左颈手术治疗食管上胸段癌 2 5例进行回顾性病例对照分析。结果 :两组肿瘤长度 ,TNM分期及肿瘤部位无差异 (P >0 0 5 ) ,肿瘤移动度左胸组大于右胸组 (P <0 0 5 ) ,除 3例肿瘤残留外 ,两组均切除成功。手术时间左胸组 (2 4 5± 4 4分钟 )少于右胸组 (2 94± 38分钟 ) (P <0 0 5 ) ,总并发症发生率左胸组 (14 % )小于右胸组 (5 0 2 % ) (P <0 0 5 )。结论 :食管上胸段癌经左胸左颈手术可行并有益 ,可以缩短手术时间 ,减少并发症发生率。病例选择以食管移动度为主要判断指标 ,直视下分离肿瘤是手术成功的关键

The Upper Thoracic Esophageal Carcinoma Operated Through Left Cervico-thoracic Approach

Objective:To evaluate the advantage and feasibility of upper thoracic esophageal carcinoma operated via left Servico-thoracic approach.Methods:From 1999 1 to 2001 10,28 patients with upper thoracic esophageal carcinoma were operated through left cervico thoracic approach,thorax and left neck,compared with 25 patients operated through right thorax.Results:No difference in size,staging and site of tumor were evident between the two groups( P >0 05).The degree of excursion of tumor in left thoracic group was greater than that in the right thoracic group( P <0 05).Except in 3 cases,the tumors were partially resected and all the other cases in both groups the tumors were completely resected.Time of operation and total incidence of postoperative complications of the left thoracic group were less than those of right thoracic group( P <0 05).Conclusion:There were advantages and feasibility in some upper thoracic esophagcal carcinoma operated through left cervico-thoracic approach.The major indication of operation through left thorax was the degree of esophageal excursion.The key of operation was to dissect the tumor from surrounding tissue completely under direct vision.