经食管床行颈部胃食管吻合术治疗食管瘤436例

Treatment Of Esophageal Carcinoma With The Cervical Esophagogastrostomy Through The Esophageal Bed: A Report Of 436 Cases.

１９８６年１月至１９９５年５月，我们采用经食管床胃食管颈部吻合治疗食管癌４３６例，取得较好的效果。全组男性２０９例，女性１２７例，年龄３０～７８岁。夹杂其他脏器疾病者占２４．１％，心电图异常者２８．９％，肺通气功能低下者２２％。术后并发症率５．７％，死亡率０．５％。术后３、５年生存率分别为７６．３％和３０．６％。作者对该术式的优点及手术应注意的问题进行了讨论，认为该术式符合生理，径程最短，操作简便易行，安全性高，病变切除彻底，创伤小，并发症少。尤其对心肺功能较差，夹杂慢性疾患的老年人及高位食管癌患者值得推荐应用。

The cervical esophagogastrostomy through the esophageal bed was performed in 436 patients with esophageal carcinoma from January 1986 to May 1995. The curative effect was good. There were 209 males and 127 females aged from 30 to 78. One hundred and five cases (24.1 %) suffered from concomitant disease. Pro-operative abnormal EKG was proved in 126 cases (28.9 % ). Deficient pulmonary ventilation function was found in 96 cases (22%). The incidence of postoperative complications and operative mortality were 5.7% and 0.5%. The 3- year and 5- year survival rates were respectively 76.3% and 30.6%. The advantages and cautions of this technique were discussed. The authors believed that the procedure of cervical anastomosis was more physiological, the distance of transposition was short, the performance was simple and easy, the operative trauma was small. The technique was particularly suitable for the aged patients with deficient cardiopulmonary function and with carcinoma of the upper segment of the esophagus.