小开胸改良切除胸中下段食管癌

Little thoracotomy and modified operation in patients with middle or low thoracic esophageal carcinoma

目的:为了改善胸中下段食管癌手术效果,减少并发症及改进手术方法。方法:我们采用小开胸直视下游离肿瘤、上段正常食管内翻剥脱,胃经食管床提至颈部吻合。结果:无手术死亡。结合综合治疗3年、5年生存率为55.2％、39.3％。结论:本术式简单、清扫更广泛、术后并发症少,治疗胸中下段食管癌是有效可行的,值得推广运用。

Purposes: To evalute the effect of improved esophagectomy on middle or low thoracic esophageal carcinoma and reduce the complications. Methods: Little thoracotomy dissection of the tumors under direct vision, the upperthorcic normal esophageal invert- stripping and esophagogastrostomy in the neck were used in operation. Results: There was no operative death. The overall 3 and 5 year surival rate were 55.2% and 39.3% respectively by the comprehensive treatment. Conclusions: The method increase tumor dissection and lymphadenectomy, decrease postoperative complications. This modified operation has many advantages for treating the patients with middle or low thoracic esophageal carcinoma, and its wide application seems justified.