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改进胸中、上段食管癌手术径路。方法 病人左侧卧位 ,后仰 45°固定于手术台上 ,先左转手术台 15°～ 2 5° ,右后外侧切口经第六肋床进胸行肿瘤切除和淋巴结清除 ;再右转手术台 15°～ 2 5° ,扩大切口成右胸腹联合切口 ,然后游离胃 ,胃过食管裂孔经食管床在颈部与食管吻合。结果 36例术中不需要变换体位既能同步完成胸腹部操作。结论 采用右颈、右胸腹联合切口径路行胸中、上段食管癌切除术 ,配合术中手术台的左右调节 ,胸腹部手术野能同时得到良好的显露 ,有利于纵隔淋巴结的清除。
Improve the chest, upper esophageal cancer surgery path. Methods The patient’s left lateral position, 45 ° back fixed on the operating table, turn left the operating table 15 ° ~ 25 °, the right posterolateral incision into the chest through the sixth rib bed tumor resection and lymph node clearance; then turn right Operating table 15 ° ~ 2 5 °, expand the incision into the right thoracoabdominal incision, and then free stomach, esophageal fissure through the esophageal bed in the neck and esophageal anastomosis. Results 36 cases of operation without the need to change position both simultaneously completed thoracoabdominal operation. Conclusion The right and left thoracoabdominal incision approach esophageal resection of the thoracic and upper esophageal cancer surgery, with the operation of the left and right operating table, chest and abdomen surgery can be well exposed at the same time, is conducive to the removal of mediastinal lymph nodes.