食管中下段癌根治性手术入路的探讨

Exploration of radical operation path in carcinoma of middle-low esophageal

目的 :探讨食管中下段癌手术路径的合理选择、手术技巧以及并发症的预防。方法 :回顾总结我院 1996年 1月～ 2 0 0 3年 12月食管癌根治性手术治疗的 191例食管中下段癌的临床资料 ,其中经左胸切口75例 ,经右胸切口 116例。结果 :经右胸切口切除食管长度足够 ,清除淋巴结彻底 ,不切开膈肌 ,吻合方便 ,对呼吸功能影响较小 ,减少手术并发症方面有一定优势 ,安全性较好。结论 :手术路径的选择主要依据肿瘤的具体情况和个人手术习惯而定 ,合理掌握手术指征。对于食管中下段癌Ⅰ。

OBJECTIVE: To discuss the proper operation path of esophageal cancer in the lower, middle sections and the prevention of surgical complications.METHODS:Clinical data of 191 patients with esophageal cancer in the lower, middle section in my hospital from Jan, 1996 to Dec, 2003 were analysed retrospectively. The opertion path included 75 left thoracic incision and 116 right thoracic incision. RESULTS:In right thoracic incision, we could resect enough longth of esophagus and dissect lymph node thoroughly, without opening the diaphragm, having easy anastomosis and small effect to respiratory function and small surgical complications.CONCLUSIONS:Choice of operation path depends on the situation of the tumor and the custom of the surgeon. The right thoracis incision is a good choice for the Stage Ⅰ,Ⅱ patients with esophageal cancer in the lower, middle section.