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Hutson氏切口受膈肌和肝左叶限制,不能充分暴露食管及其周围纽织。作者作了改良;切开食管裂孔的部分膈肌,在胸膜处显露出一部分隔开食管;令患者右侧半卧位,以减少心脏对后下纵隔的遮盖,这样,可对食管及其周围淋巴结施行较彻底切除,井可将吻合口放在后纵隔内。本改良切口适用于胃近段癌侵犯食管少于2cm或不宜开胸的病例。14例实践证明,术野暴露效果不亚于经胸或胸腹联合途径,而且操作省时,省力,合并症少。
The Hutson’s incision is limited by the diaphragm and the left hepatic lobe and does not adequately expose the esophagus and its surrounding neoplasia. The author made an improvement; cut part of the diaphragm of the esophageal hiatus, revealed a part of the separated esophagus at the pleura; place the patient in the right semi-recumbent position to reduce the cover of the posterior mediastinum of the heart, so that the esophagus and its surrounding lymph nodes can be Perform a more thorough resection and place the anastomosis in the posterior mediastinum. The modified incision is suitable for cases where the proximal stomach cancer violates the esophagus less than 2cm or is not suitable for opening the chest. 14 cases have proved that the surgical field exposure effect is no less than the transthoracic or thoracoabdominal joint approach, and the operation is time-saving, labor-saving, complications less.