论文部分内容阅读
开胸手术切除肿瘤并行相应区域淋巴结清扫,是食管贲门癌首选的治疗方法,效果肯定。但一些高龄或有严重呼吸及循环系统伴发病的患者,不能耐受开胸手术,而不开胸食管内翻剥脱术则为这类患者提供了手术治疗的机会。不开胸食管内翻剥脱术是指经颈部和腹部两个切口,将食管的上下端切断,再采用类似大隐静脉内翻剥脱的方法,将食管向上或向下内翻剥脱出,然后将胃或结肠提至颈部与残余食管或咽底吻合以重建食管。由于这种手术方法避免了开胸,因而具有对心肺功能影响小、手术时间短、术后恢复快等优点。但此术式在肿瘤病灶的彻底切除和区域淋巴结清扫方面受到一定限制。尽管如此,笔者认为,食管内翻剥脱术对于部分食管贲门癌患者仍不失为一种可供选择的
Thoracic surgery to remove the tumor and parallel regional lymph node dissection is the preferred treatment for esophageal and cardiac cancer. However, some patients with advanced age or severe respiratory and circulatory system diseases cannot tolerate thoracic surgery, and open thoracic esophageal evacuation surgery provides surgical treatment for these patients. Not open chest esophageal inversion surgery refers to the cut through the neck and abdomen, cut the upper and lower end of the esophagus, and then similar to the saphenous vein inversion peeling method, the esophageal up and down inversion peeling, and then Lift the stomach or colon to the neck to fit the remnants of the esophagus or the pharynx to rebuild the esophagus. Because this method of operation avoids opening the chest, it has the advantages of small effect on heart and lung function, short operation time, and quick postoperative recovery. However, this surgical method is limited in the complete removal of tumor lesions and regional lymph node dissection. Despite this, the author believes that esophageal involution surgery is still an option for some patients with esophageal cardiac cancer.