经右胸-食管裂孔游离胃治疗胸上中段食管癌

An operation via right thoracicesophageal hiatus for cancer of upper or middle esophageal

目的研究经右胸切口一食管裂孔游离胃治疗胸上中段食管癌的可行性。方法对46例上中段食管癌患者行经右胸切口,扩大食管裂孔,经食管裂孔游离胃,行食管胃右胸顶吻合或左颈部吻合。结果肿瘤切除率100%(46/46)。发生颈部吻合口瘘1例(2.17%1/46),胃残端瘘1例(2.17%1/46),肺部并发症患者5例(1 0.87%5/46),喉返神经损伤患者1例(2.17%1/46)。1例(2.17%1/46)残胃瘘患者死亡。结论对于中上段食管癌患者,经右胸切口-食管裂孔游离胃是一种较为理想的手术方式。

Objective To investigate the feasibility of an operation via right thoracicesophageal hiatus for cancer of upper or middle esophageal.Methods Form 2009 to 2013,46 patients of cancer of upper or middle esophageal are operated via right thoracic,Enlarging esophageal hiatus,mobilizing the stomach through esophageal hiatus;the esophagus and stomach are anastomosed located in right cupula pleurae or left neck.Results46（100%） patients underwent the complete resection.The main complications include neck anastomotic stoma fistula（2.17% 1/46）, gastric stump fistula（2.17% 1/46）,lung diseases（10.87%,5/46）,injury of recurrent nerve（2.17% 1/46）.1（2.17% 1/46） patient was death because of gastric stump fistula.Conclusion Operation via right thoracicesophageal hiatus is a effective for patients with cancer of upper or middle esophageal.