累及主动脉弓段食管癌手术分析

目的:分析左侧入径治疗累及主动脉弓段的食管瘤手术特点.方法:连续观察51例累及主动脉弓段食管癌外科治疗,手术经左侧入径.手术切除41例,占80.6%,其中颈部吻合38例,主动脉弓上吻合3例;手术探查10例,占19.4%,不能切除的主要原因是肿瘤外侵,侵及主动脉及支气管等局部重要结构.结果:本组无死亡,术后17例发生20项并发症,占33%,经治疗恢复.结论:累及主动脉弓段食管癌周围结构复杂,与其它部位中下段食管瘤手术相比,切除率低,并发症发生率高.应强调术前评估、术中注意局部解剖和术后加强管理.

Analysis of the operation of esophageal carcinoma involving aorticarch

Objective:To analyse the characteristics of the operation of esophageal cancer involving aortic arch from left ap-proach. Methods: Sequentially observing 5lcases of surgical treatment of esophageal carcinoma involving aortic arch.The left approach was applied in this group.The tumor of 41 cases were removed, account for 81.6% ,38 cases anastomosed in neck, 3 cases were anas-tomosed above aortic arch. 10 cases were explored but not removed, account for 19.4%, the main reason was tumor invading the im-portant structures, such as aortic arch, bronchus. Results: no death in the group. 17 cases had 20 times complications, the incidence was 33% , but all recovered after the treatment. Conclusions: The structures around esophageal carcinoma in aortic arch part are much com-plex . The remove rate is obviously lower and the complications are higher than other parts. The evaluation before the operation should be stressed, the attention should be paid to the local anatomy during the operation, and the management after the operation must be strengthened.