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本文报告非开胸食管切除术治疗食管贲门癌13例、其中贲门癌10例、颈段癌2例、下段癌1例。术后发生颈部切口感染及/或吻合口漏11例,均经换药治愈,无其它严重合并症及手术死亡。本术对贲门及预段癌兼有心肺功能低下者尤为适用。手术经腹及颈部切口将食管内翻拔脱、将胃或保留胃窦之胃管经食管床上提至颈部与食管吻合,胃管成形后的自然长度一般以20cm左右为宜、过长过短均不利于吻合口的愈合。术中应加强保护隔离技术防止污染伤。
This article reports non-thoracotomy esophagectomy for 13 cases of esophageal and cardiac cancer, 10 cases of cardiac cancer, 2 cases of cervical cancer, and 1 case of lower cancer. Postoperative neck incision infection and/or anastomotic leakage occurred in 11 cases, all of which were cured by dressing change, and no other serious complications and surgical death occurred. This technique is particularly suitable for cardiopulmonary and pre-cancer patients with both cardiopulmonary dysfunction. The abdominal and cervical incisions are performed to remove the esophagus and invade the stomach. The stomach or the stomach tube of the antrum is preserved through the esophageal bed to the anastomosis of the neck and esophagus. The natural length of the stomach tube is usually about 20cm. Too short is not conducive to anastomotic healing. Intraoperative protection and isolation techniques should be strengthened to prevent contamination.