食管大部切除、颈前肌群悬吊式食管胃颈部一层吻合术治疗食管中上段癌

Subtotal esophagectomy with one layer cervical esophagogatrostomy for carcinoma in middle and upper thoracic esophagues

针对传统治疗高位食管瘤的标准术式所存在的问题，总结1995年1月至1996年9月我们采用的新术式和结果。全组185例，病变位于胸上段（35）或高位胸中段（150），食管切除后以文中所述方式在颈部重建食管。无手术死亡，无吻合口狭窄。吻合口瘘13例（7％），喉返神经损伤2例（1％）。认为本术式符合肿瘤根治原则，主要并发症发生率低于传统术式，简单方便，安全可靠。

Summarized the experience of this new procedure used in our department from Jan 1995though Sep 1996, introduced key techiniques of the operation, and analysed these results. A total of 185cases with the esophageal carcinoma in thoracic middle of upper segment were operated on with this newoperation. There was no operative mortality and anastomostic stenosis. The incidences of anastomosticleakage/fistula and injury of recurrent larygeal nerve were 7%, 1%, respectivaly. we think this modifiedoperation not only still remains the principle of oncological treatment with the advantages of simplicityand safety, but also can prevent the incidences of main operative complications, especially for anastomostic stenosis and injury of recurrent larygeal nerve.