非开胸食管剥脱术在食管癌手术治疗中的应用﹙附21例报告﹚

Application of esophagectomg without thoracotomy in surgical treatment of esophageal carcinoma

目的为了扩大外科治疗食管癌的范围,减少并发症,提高手术效果,介绍非开胸食管剥脱术的方法。方法总结我院以往12年来21例用非开胸食管剥脱术治疗食管癌的经验。结果全组患者均获得切除,无手术死亡,其中8例生存逾5年。术中失血150～200ml。术后发生颈部吻合口瘘2例﹙9.5%﹚,喉返神经暂时性麻痹2例﹙9.5%﹚。结论应用本方法是治疗食管癌的一种可行的手段,具有简便、安全的特点。对年龄较大,心肺功能差的病人效果更好。但选择合适的病人非常重要。

Objective To extent the range of surgical therapy for esophageal carcinoma to decrease the complication of operation and to improve the effect of operation. Present the mode of invert stripping of the esophagus without thoracotomy. Methods 21 cases of esophageal carcinoma treated with the approach during the past 12 years in Jianhu People's Hospital were retrospectively studied. Results No patients was died due to operation. 8 cases survived for more than 5 years. The blood loss was 150-200ml. The cervical fistula occurred in 2 cases﹙9.5%﹚and temporally recurrent nerve injury in 2 cases﹙9.5%﹚after operation. Conclusions This mode is a feasible, simple and safe procedure for treatment of esophageal carcinoma. It has better effect to the old patients with abnormal heart and pulmonary functions. The cases should be properly selected to adapt to the approach.