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目的 :探讨该根治术式在贲门癌手术中的实用性 ;方法 :患者平卧位 ,上腹正中切口 ,上至胸骨第 3肋水平 ,下达脐。正中劈开胸骨 ,牵拉开胸骨、腹部切口 ,使膈肌 ,胃均暴露在直视下。按胃癌根治规约进行胃癌根治术 ,在游离食管时 ,把纵隔膈肌纵行打开 ,游离出食管下段 5cm ,与胃行端端吻合术。吻合后把吻合口放在纵膈食道床内 ,关闭膈肌 ,用钢丝缝合胸骨 ,逐层缝合胸腹切口术毕。结果 :经与传统术式a 左侧开胸入路 ;b 经腹入路 ;c 胸腹联合切口入路 ,进行对比 ,此术式避免开胸 ,使贲门部肿物暴露在直视下 ,使较为困难的操作变为容易。结论 :此术式对有肺疾患者 ,肺功能较差 ,体弱年老患者较为安全。它不失为贲门癌根治术式中的一种可选择的手术入路。
Objective: To explore the practicality of the radical operation in cardiac cancer surgery;Methods: Patient supine position, mid abdominal incision, up to the third sternal level, and umbilicus. The sternum was opened in the middle, and the sternum and abdomen incision were pulled so that the diaphragm and stomach were exposed under direct vision. According to the radical gastrectomy for gastric cancer, when the free esophagus is opened, the diaphragm of the mediastinum is opened longitudinally, and the lower esophageal segment is 5cm apart, and the end of the stomach is anastomosed. After anastomosis, the anastomosis was placed on the mediastinal esophagus bed, the diaphragm was closed, the sternum was sutured with steel wire, and the thoracoabdominal incision was sutured layer by layer. RESULTS: After the open thorax approach to the left side of the conventional surgical technique a; b transabdominal approach; c thoracoabdominal combined incision approach, a contrast was made. This procedure avoids opening the thorax and exposes the cardiac tumor mass under direct vision. Make difficult operations easier. Conclusion: This surgical procedure is safer for patients with pulmonary disease and poor lung function. It is an alternative surgical approach in the surgical treatment of cardiac cancer.