食管次全切除、胃代食管颈部吻合治疗食管中、上段癌132例

Subtotal esophagectomy for treatment of 132 patients with middle and upper esophageal carcinoma through cervical anastomosis

目的 探讨食管中、上段癌行食管次全切除术式的利弊及疗效评价。方法 采用经右胸、上腹和左颈 (三切口 )或左胸和左颈部 (二切口 )切除食管病变。结果 此术式肿瘤切除和淋巴结清扫彻底。虽然颈部吻合口瘘发生率较高 ( 12 .8% ) ,但伤口容易引流 ,预后良好。结论 食管癌次全切除 ,左颈部吻合治疗中、上段食管癌利多弊少 ,是一种安全可靠的术式 ,并能提高病人的生存率。

Objective To investigate the advantages and disadvantages and to evaluate the curative effect of subtotal esophagectomy for treatment of middle and upper esophageal carcinoma. Methods The esophageal carcinoma was resected through right chest,upper abdomen and left neck(3 incisions)or left chest and left neck (2 incisions). Results This operative pattern can radically remove carcinoma and extensive lymph nodes.Although cervical anastomosis leakage has higher incidence (12.8%),the management of such complication is relatively easy and the cure is rapid. Conclusion Subtotal esophagectomy is more advantageous and a safe and effective operative pattern,and raises the patients' survival rate.