三切口食管-胃单层宽边颈部吻合行胸上段食管癌根治术临床研究

Clinical study of the esophagus-stomach and cervical anastomosis with single layer and broad border suture take in upper thoracic esophageal cancer radical operation

目的：研究胸上段食管根治术中采取右侧颈胸腹三处切口及食管-胃单层宽边吻合的临床治疗效果。方法：我们医疗组自1996年6月～2008年6月共治疗胸上段食管癌199例，其中行根治性手术189例，术中采用颈胸腹三处切口入路，胃与食管吻合采用单层宽边方法、胃代食管。结果：全组无手术死亡，出现吻合口漏1例、吻合口狭窄5例、幽门梗阻2例、再次开胸止血1例、胸腔感染2例以及乳糜胸1例、随访143例，五年生存率为31．2％。结论：此术式简便有效，局属淋巴结清扫方便，彻底，值得推广。

Objective： Research on the clinical therapeutic effection of in the upper thoracic esophagus radical mastectomy to take the right common carotid three thoracoabdominal incision and esophagus-stomach anastomosis with single layer broad border suture. Methods：Our medical team since June 1996 to June 2008 on the treatment of upper thoracic esophageal cancer 199 cases, radical surgery in which 189 cases, intraoperative use of carotid three thoracoabdominal incision approach, stomach and esophageal anastomosis method using single layer broad brimmed, stomach replacement of esophagus technique. Results ：There were no operative death, occurred anastomosis leakage in 1 case, 5 cases of anastomosis stenosis, 2 cases of pyloric obstruction, 1 case of hemostasis in rethoraeotomy, 2 cases of chest infection and 1 case of chylothorax, 143 cases of followup, 5 years survival rate was 31.2%. Conclusion： These procedures are simple and effective, convenience and complete to clean the relative location lymphonodus, worthy of promotion.