论文部分内容阅读
正987年3月至1994年3月,经左胸左颈部切口,手术治疗食管上段癌58例,取得较好近期疗效。本术式要点是:(1)经左胸后外侧第6肋间开胸,游离牵开主动脉弓后切除胸内全食管[1],清除周围淋巴结;(2)切开隔肌充分游离全胃,使胃的长度达到最长限度;(3)左颈部切口与胸腔沟通,钝性扩张胸廓入口间隙;(4)延长食管粘膜层长度[2],食管断端切成斜面状;(5)胃缝缩经食管床提至颈部与食管吻合[3]。并发吻合口瘘2例,无狭窄和手术死亡。
From March 1987 to March 1994, 58 patients with upper esophageal cancer underwent surgical treatment of left thoracic and left cervical incisions and achieved good short-term efficacy. The main points of this surgical procedure are: (1) 6 th intercostal thoracotomy through the left posterolateral left chest, free retraction of the aortic arch, resection of the intrathoracic total esophagus [1], removal of surrounding lymph nodes; (2) incision of the septal muscles to fully free the whole stomach The length of the stomach is maximized; (3) the left neck incision communicates with the chest cavity and the thoracic infiltrate gap is bluntly dilated; (4) the esophageal mucosal layer length is extended [2] and the esophageal end is cut into a slant; (5 ) Stomach suture reduction through the esophagus bed to the neck and esophageal anastomosis [3]. Anastomotic leakage occurred in 2 cases, no stenosis and operative death.