胃经食管床主动脉弓后或弓上吻合术治疗中段及中上段食管癌

【作者】 沈毅； 王勇杰； 徐琦； 林乐胜；

【机构】 青岛大学医学院附院胸外科；

【摘要】 目的探讨应用新术式治疗食管中段癌及部分中上段癌的疗效。方法回顾性总结经食管床主动脉弓后或弓上吻合的食管癌根治术326例的疗效。其中食管中段癌289例,食管中上段癌37例。肿瘤长度范围2～12 cm。术后病理报告均为鳞状细胞癌。全部食管切缘均阴性。TNM分期:I期54例,Ⅱ期～Ⅲ期235例。结果全部食管切缘均阴性。术后发生吻合口瘘2例;吻合口狭窄12例;无手术近期死亡。术后可良好耐受放、化疗等综合性治疗。结论剖左胸用弯管型吻合器经食管床行主动脉弓上或胸顶食管胃端侧吻合是一种切实可行的术式,优点突出,并发症少,有利于提高患者长期生活质量。对部分食管中上段癌亦有较高应用价值。更多还原

【Abstract】 Objective:To evaluae the result of surgical treatment of the middle and upper esophageal carcinoma with a new operation performing the anatomosis posterior to the aortic arch in esophageal bed. Method: 326 patients with esophageal carcinoma were treated by esophagogatrostomy. The site of esophagogastric anastomosis was underwent through esophageal bed and posterior to the aortic arch . All of them were squamous cell carcinoma. The lesions were stage I 54 and stage II -III 235. Result:All patients have been alive after follow-up of Smonths to 5 years. All patients ha- ven’t any positive margins or perioprative death . There were 2 anatomotic leak ,12 anatomotic at-ricture and 34 gastroesophageal reflux in patients . Conclusion:The new method has less complications and improves long-term life quality of the patients. Key word esophageal carcinoma /surgery ; anastomosis , surgical更多还原