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目的 分析颈段食管癌手术的特点，增加切除率，减少并发症，延长生存期。方法 对４１ 例颈段食管癌外科治疗，以不同的切口切除肿瘤，周围汇集的淋巴结及附着的脂肪组织，以胃、结肠代替食管，经不同途径，行颈部吻合。经颈—右胸—腹，胃代食管２０ 例，右半结肠代食管２ 例。经颈—左胸，胃代食管１５ 例（ 主动脉弓后９ 例） 。经颈—胸骨后—腹，右半结肠２ 例，左半结肠２ 例。结果 有９ 例（２２ ％ ） 发生并发症，２ 例死亡，其余多经治疗恢复。１ 例术后全喉切除，气管造口，死于吻合口瘘纵隔感染。吻合口瘘３ 例，１ 例死亡，２ 例经换药、胃小肠造瘘供应营养后治愈。有３５例随访（８５ ％ ） ，６ 例失访。２ 例生存７ 月，４ 例生存１０ 月，４ 例生存１ 年，５ 例生存１－５ 年，４ 例生存２ 年，７ 例生存３ 年，９例生存５ 年。结论 颈部食管癌周围解剖结构复杂，与中下段食管癌手术相比，切除率低，并发症发生率高。术中必须注意局部解剖结构，尽可能廓清淋巴结，避免上切端阳性率，精细吻合，术后加强护理，减少并发症，提高生活质量，必能延长生存期。
Objective To analyze the characteristics of cervical esophageal cancer surgery, increase resection rate, reduce complications and prolong survival. Methods Surgical treatment of 41 patients with cervical esophageal cancer was performed. The tumors were excised with different incisions. The lymph nodes and attached adipose tissue were collected. The esophagus was replaced by stomach and colon, and the anastomosis was performed by different means. The neck - right chest - abdomen, stomach on behalf of the esophagus in 20 cases, right esophagus on behalf of the esophagus in 2 cases. The neck - left chest, stomach on behalf of the esophagus in 15 cases (9 cases after aortic arch). After the neck - sternum - abdominal, right half colon in 2 cases, left half colon in 2 cases. Results Nine patients (22%) had complications, two died, and the rest recovered after treatment. One case of total laryngectomy, tracheostomy, died of anastomotic fistula mediastinal infection. Anastomotic fistula in 3 cases, 1 patient died, 2 cases after dressing, gastrointestinal fistula supply nutrition cure. 35 cases were followed up (85%), 6 cases were lost. Two survived in July, four survived in October, four survived for one year, five survived for 1-5 years, four survived for two years, seven survived for three years and nine survived for five years. Conclusion The anatomy of cervical esophageal cancer is complex. Compared with the operation of middle and lower esophageal cancer, the resection rate is low and the complication rate is high. Surgery must pay attention to the local anatomy, lymph node dissection as much as possible to avoid the positive rate of incision, fine anastomosis, postoperative care, reduce complications and improve quality of life, will be able to extend the survival period.