经左胸颈段食管胃机械吻合术治疗216例食管癌

Treating 216 cases of cancer of the esophagus by using mechanical anastomosis connecting neck esophagus and stomach through the left chest

目的 :针对食管癌根治切除后传统吻合术存在的不足 ,探讨使用新的手术方式。方法 :应用食管次全切除、经左胸颈段食管胃机械吻合术治疗胸中、上段食管癌 2 16例。结果 :所有病例均一次性吻合成功 ,全组无手术死亡 ,无吻合口瘘及喉返神经、胸导管损伤等严重并发症。随访 2年以上的 96例无吻合口复发癌及中重度吻合口狭窄。结论 :本术式较传统术式简便、安全、疗效确切 。

Purpose:In view of the deficiency of the traditional anastomosis in curative surgery in cancer of the esophagus, a new way of operation is discussed. Methods:Cutting off almost the whole esophagus and performing mechanical anastomosis connecting the neck esophagus and stomach through the left chest was the treatment for 216 cases of cancer of esophagus occurring in the middle and upper part. Results:Alll the cases anastomosed successfully by first intention without seriuos complication such as deaths at operation, fistula at anastomosis end,serious injury of recurrent laryngeal nerve and chest vessels. Ninety six cases are found to be well without recurrent cancer or stricture of medium or serious level at anastomosisc end after 2 years of visting. Conclusions:This new way of operation is more simple and convenient as well as safer. It has a definite therapeutic effect. The occurrencerate of the main complications at operation was reduced markedly.