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目的 探讨食管内翻拔脱术在食管癌、贲门癌外科治疗中的地位。方法 19例食管癌、贲门癌病人接受了食管内翻拔脱术 ,其中食管鳞癌 15例 ,颈段 3例 ,胸中段 6例 ,胸下段 6例 ;贲门腺癌 4例。 0期 1例 ;Ⅰ期 4例 ;Ⅱa期 4例 ;Ⅱb期 1例 ;Ⅲ期 9例。 3例因有上消化道手术史行结肠代食管。结果 19例均获切除 ,食管切缘阴性 ,无手术死亡。术后声音嘶哑 1例 ,心律失常1例 ,双侧胸腔积液 1例 ,左侧气胸伴左膈下脓肿 1例 ,5例出现小的颈部吻合口瘘。结论 食管内翻拔脱术扩大了食管癌、贲门癌的手术适应证 ,使某些常规手术高危患者重新获得手术机会。
Objective To investigate the status of esophageal varus extraction surgery in the surgical treatment of esophageal and cardiac cardia cancer. Methods Twenty-nine patients with esophageal and cardiac cancer underwent esophageal variceal esophagectomy. Among them, 15 were esophageal squamous cell carcinoma, 3 were cervical, 6 were middle thoracic, 6 were lower thoracic and 4 were cardiac adenocarcinoma. 0 in 1 case, 4 in stage I, 4 in stage IIa, 1 in stage IIb and 9 in stage III. 3 cases due to the history of upper gastrointestinal colon on behalf of the esophagus. Results All the cases were resected, the esophageal resection margin was negative and no operation died. 1 case of hoarseness after operation, 1 case of cardiac arrhythmia, 1 case of bilateral pleural effusion, 1 case of left pneumothorax with left subphrenic abscess and 5 cases of small neck anastomotic fistula. Conclusions Esophageal varus extraction expands the indications for esophageal and cardia cancers and regains the chances of surgery in some high-risk patients undergoing conventional surgery.