【摘要】 Hutson氏切口受膈肌和肝左叶限制,不能充分暴露食管及其周围纽织。作者作了改良;切开食管裂孔的部分膈肌,在胸膜处显露出一部分隔开食管;令患者右侧半卧位,以减少心脏对后下纵隔的遮盖,这样,可对食管及其周围淋巴结施行较彻底切除,井可将吻合口放在后纵隔内。本改良切口适用于胃近段癌侵犯食管少于2cm或不宜开胸的病例。14例实践证明,术野暴露效果不亚于经胸或胸腹联合途径,而且操作省时,省力,合并症少。更多还原

【Abstract】 Hutson’s incision, limited by the diaphragm and the left lobe of liver,does not afford satisfactory exposure of the higher portion of the esophagus and its surrounding tissues. The author made some modifications by cutting open diaphragm surrounding the esophageal hiatus to expose the supradiaphragmatic portion of the esophagus extrapleurally with the patient placed on the right semilateral position to minimize the covering effect of heart to the posteroinferior mediastinum. Consequently it is possible to perform a more complete excision of the esophagus with nearby lymph nodes, and to put the anastomosis in posterior mediastinum as required. This modified incision is chiefly used for the proximal gastric cancer involving esophagus less than 2 cm or under circumstances where thoracotomy is unsuitable. Our 14 cases showed that this new procedure could afford a better exposure and could be performed easier with less complications.更多还原