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目的 :应用改进的三切口方法手术治疗食管癌 ,探讨食管癌的切除率、根治彻底性、围手术期并发症、术后复发及临床疗效和长期生存率之问题。方法 :对连续收治的食管癌 5 6 0例均采用改进的手术方法 (右上腹直肌 /右胸后外侧 /右颈部 )三切口进行手术治疗并作回顾性分析。结果 :通过该手术方法治疗的 5 6 0例病人中围手术期并发症发生率 9 3% ,手术切除率 99 6 % ,无手术死亡 ,无吻合口瘘发生。 1、2、3、5年生存率分别为 86 1%、71 4 %、6 3 6 %和 4 4 7%。结论 :改进的三切口手术方法可明显降低围手术期并发症 ,尤其是吻合口瘘等重要并发症 ,可明显提高手术切除率、淋巴清扫的彻底性及减少术后复发 ,提高生活质量和远期生存率 ,该三切口治疗食管癌是目前食管癌根治性手术治疗效果较好的临床方法。
OBJECTIVE: To study the surgical treatment of esophageal cancer with the improved three-incision method to investigate the resection rate, thorough radical treatment, perioperative complications, postoperative recurrence, clinical efficacy and long-term survival rate of esophageal cancer. Methods: Five hundred and seventy cases of consecutive esophageal cancer were treated surgically by modified operation method (right upper rectus abdominis / right chest posterolateral / right neck) and retrospectively analyzed. Results: The perioperative complication rate was 93% and the surgical resection rate was 99.6% in the 560 patients treated by this surgical method. There was no operative death and no anastomotic fistula occurred. The 1, 2, 3, 5-year survival rates were 86.1%, 71.4%, 63.6% and 44.7% respectively. Conclusion: The improved triple incision method can significantly reduce the perioperative complications, especially anastomotic leakage and other important complications, can significantly improve the surgical resection rate, the thoroughness of lymph node dissection and reduce postoperative recurrence, improve quality of life and far Term survival rate, the three incision for the treatment of esophageal cancer is the current radical surgical treatment of esophageal cancer better clinical approach.