颈段食管癌的外科治疗

Surgical treatment of cervical esophageal carcinoma

目的 :探讨颈段食管癌采用横断气管径路切除的手术方法及效果。方法 :在全麻气管插管下 ,颈部取“U”形切口 ,于 2～ 3气管环之间把气管横断 ,切除肿瘤并清扫淋巴结 ,于食管入口处把食管切断 ,行非开胸食管内翻拔脱 ,经食管床将胃拉至颈部行咽胃吻合。结果 :2 3例中 ,术后并发喉返神经损伤者 8例 ,颈部切口感染者 2例 ,咽胃吻合口瘘者 3例。均治愈出院 (1例于术后 8个月死于肺部感染 )。 15例生存超过 3年 ,3例生存超过 5年。结论 :横断气管径路切除食管癌是一种有效的手术方法 ,为颈段食管癌的外科治疗提供了一种新的手术路径。

Objective:To review the experience of tracheal transection in the operation of cervical esophageal carcinoma.Methods:Under the tracheal intubation anesthesia, Juguler incision was made like U. tracheal was transected between 2ed and 3rd tracheal rings, then carcinoma was resected and the lymphnodes was cleared away, Esophageal was resected in introitus esophageal before inversion-stripping esophagectomy without Thoracotomy, pharynx-stomach anatomosis was operated in the cervical.Results:No operation death was noted, and anastomotic leakage occurred in 1 patient, recurrent nerve injury in 8 patients, incision infection of neck in 2 patients. 1 patient was died of the lung infection in 8 months, 15 patients lived over 3 years, 3 patients lived over 5 years.Conclusion:It is concluded that the new approach for the treatment of cervical esophageal carcinoma is effective and safe.