食管癌外科治疗体会

［目的］探讨外科治疗食管癌的经验。［方法］自１９８８年至１９９８年对１００例食管癌施行切除术，其中上段８例，中段７２例，下段２０例，手术入路计经左颈、右胸、腹部三切口１８例，右胸、腹部二切口４９例，右胸后外侧单切口５例，左后外侧单切口 ２８例，切除食管后均作食管胃一层间断吻合重建消化道。［结果］住院死亡４例，死亡率为４％，术后发生吻合口瘘２例。术后５年生存率为３７．２％（１６／４３）。［结论］食管癌的手术入路应取决于病灶的所在部位；主张一层食管胃吻合术重建消化道；为了提高食管癌术后的生存率，必须作广泛的食管切除及彻底的淋巴结清扫。

The Experience of Surgical Treatment for Esophageal Carcinoma

Purpose]To Study the experience of surgical treatment of esophageal carcinoma. Method]One hundred patients with esophageal carcinoma were operated form 1988 to 1998.The lesions were at the upper esophagus in 8 cases,the middle in 72 cases and the lower in 20 cases. The operative approaches included combined left cervical, right chest and abdominal incisions in 18 cases, combined right chest and abdominal incisions in 49 cases,right posterolateral thoracotomy in 5 cases, and left posterolateral thoracotomy in 28 cases. One layer anastomosis between the stomach and the esophagus was performed after esophageal resection in all cases.Results]Four patients died during hospitalization,with a hospital mortality of 4% .The anastomotic fistula fistula was found in 2 cases after operation.The 5 - year survival survival rate was 37.2% (16/43). Conclusion]The operative approach of esophageal carcinoma was depended on the position of the lesion. One layer anastomsis between the stomach and the esophagus was recommended.For raising the survival of the patients with esophageal after operation,it is necessary to resest esophagus extensively and to resect the lymph nodes completely.