食管癌切除经食管床行弓上胃食管单层吻合术体会

The discussion of esopagectomy above aortic arches for esophagogastrostomy in esophageal bed

目的 探讨食管癌切除经食管床行弓上胃食管单层吻合方法及效果。方法 对 1997年 12月～2 0 0 2年 12月收治的食管胸中段癌和食管胸下段癌 16 7例进行临床资料分析。结果 根治性切除 15 4例 ,姑息性切除 13例 ,切除率 10 0 %。术后出现吻合口瘘 1例 ,肺部感染 4例 ,包裹性脓胸 2例 ,返流性食管炎 8例 ,并发症的发生率为 8 9% ( 15 /16 7) ,无吻合口狭窄及乳糜胸病例发生。结论 该术式操作方便 ,食管病变能得到较大范围切除 ,吻合口周围松弛 ,上下通畅 ,血运佳 ,符合生理要求 ,疗效好 ,并发症的发生率低。

Objective To discuss the operative methods and curative effect of esophagectomy above aortic arches for esophagogastrostomy in esophageal bed.Methods To analyse clinical data about 167 patients of the middle and underneath esophageal cancer from December 1997 to December 2002.Results The 154 patients underwent complete resection the 13 patients underwent palliative operation, exision rate was 100%.After operation 1 case complicated anastornotic leak,4 cases infection, 2 cases package thorax fester,8 cases reflux esophageal in flammation,postoperative comlications rate was 8.9%(15/167), no case anastomosis stricture and chylothorax. Conclusion The operation fashion is convenient, the esopageal neoplasms exision area is more large,anastomosis slack,esopageal unblocked, blood circle good, accord with physiological demand, curative effect is good, postoperative complications rate is low.