左胸单切口胸膜顶食管胃吻合在食管中上段癌手术中的应用

Esophagogastric anastomosis of pleura cupula with single left thoracal incision used in the upper-middle segmental esophageal cancer

目的探讨胸内中上段食管癌的外科手术治疗方法。方法对68例经左胸单切口行食管癌切除,胸膜顶(或超胸膜顶)应用CDH吻合器行食管胃吻合治疗的食管癌进行回顾性分析。结果手术无机械故障,亦无手术死亡。术后无吻合口瘘,无吻合口出血及狭窄。结论大部分常规颈部食管胃吻合术可用CDH吻合器行胸膜顶(或超胸膜顶)食管胃吻合术,达到全胸段及部分颈段食管切除,清扫淋巴结的范围基本达技术要求。由于该术式手术切口减少,操作简化,明显缩短手术时间,减轻手术创伤,值得临床推广。

Objective To study the surgical therapeutic methods of upper-middle segmental esophageal cancer. Methods From March 2000 to March 2006, 68 cases received via single left thoracal incision for esophageal cancer and esophagogastric anastomosis at cupula of pleura with CDH stapler were analyzed retrospectively. Results There was no mechanical out of order and operative death during operation. No leakage, bleeding and stenosis of anastomosis were found after operation. Conclusion Esophagogastric anastomosis at the cupula of pleura with CDH stapler can be used in the most of routine cervical esophagogastric anastomosis .It would reach to esophageal resection of total thoracic segment or partial incisions, simplified manipulation, cervical segment. This surgical procedure possesses reducing shortening operative time and less orperative trauma.