食管中段癌切除吻合口部位的选择

THe Choice of Anastomotic Position in Resection of Middle EsophagealCarcinoma

作者对１６４例食管中段癌作了切除术，其中颈部食管胃吻合术３９例，上下切缘无残留癌，发生吻合口瘘４例，均治愈。胸内食管胃弓上吻合１２５例，发生吻合口瘘６例，死亡１例，上切缘残留癌１０例。作者对颈部和胸内两种部位吻合作了比较和分析，认为食管中段癌切除颈部吻合利多弊少，切除长度足够，无残留癌组织，即使发生了吻合口瘘，治疗也容易，大多能痊愈出院。

One hundred and sixty-four middle esophageal carcinoma patients underwent resection. Amongthem,thirty-nine cases were treated with neck anastomosis of esophagus and stomach.There were no residualcancers at the esophageal and gastric incisal margins. Anastomotic fistula occurred in four cases but they allwere cured While in one hundred and twenty-five cases treated with anastomosis of esophagus and stomach up-per the aortic arch in thoracic cavity,anastomotic fistula occurred in six cases and one die,ten cases werefound to have residual cancer at the esophageal incisal margin. These two anastomotic positions have been com-pared and analysed.The authors believe that neck anastomosis of esophagus and stomach in the resection ofmiddle esophageal carcinoma is more advantageous and the resection length is full,there is no residual cancer atthe cutting margins;even if anastomotic fistula occurred,it is easily to be treated.