手术通路的选择1933年Oshawa报告经左胸切除胸段食管同时立即食管吻合。左胸通路可对中、下1/3食管癌或贲门癌切除,但对主动脉弓水平癌的游离切除困难。1946年Lewis采用经右侧开胸食管切除,食管胃吻合,避免了开左胸的一些问题。以后Ellis经右胸及腹手术,对上、中1/3食管癌采用右胸通路较好, Choice of Surgical Pathway In 1933 Oshawa reported a left thoracic resection of the thoracic esophagus with an immediate esophageal anastomosis. The left thoracic approach can excise the middle and lower 1/3 esophageal or cardiac cancers, but it is difficult to remove the aortic arch horizontally. In 1946, Lewis used a thoracotomy on the right side and an esophagogastric anastomosis to avoid some problems in opening the left chest. Later, Ellis had right chest and abdominal surgery, and had better right chest access for upper and middle 1/3 esophageal cancer.