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目的研究经右胸切口一食管裂孔游离胃治疗胸上中段食管癌的可行性。方法对46例上中段食管癌患者行经右胸切口,扩大食管裂孔,经食管裂孔游离胃,行食管胃右胸顶吻合或左颈部吻合。结果肿瘤切除率100%(46/46)。发生颈部吻合口瘘1例(2.17%1/46),胃残端瘘1例(2.17%1/46),肺部并发症患者5例(1 0.87%5/46),喉返神经损伤患者1例(2.17%1/46)。1例(2.17%1/46)残胃瘘患者死亡。结论对于中上段食管癌患者,经右胸切口-食管裂孔游离胃是一种较为理想的手术方式。
Objective To study the feasibility of transposition of the right thoracic incision and esophageal fissure free stomach in the treatment of middle and upper esophageal cancer. Methods Forty-six patients with upper and middle esophageal cancer underwent right chest incision, esophageal foramen enlargement, esophageal fissure free stomach, right esophageal right chest anastomosis or left anastomosis. Results Tumor resection rate was 100% (46/46). One case (2.17% 1/46) of the anastomotic fistula, one case of gastric stump fistula (2.17% 1/46), 5 cases of pulmonary complications (1.87% 5/46) and recurrent laryngeal nerve injury 1 patient (2.17% 1/46). One patient (2.17%, 1/46) died of residual gastric fistula. Conclusion For the middle and upper esophageal cancer patients, the right thoracic incision - esophageal hiatus free stomach is a more ideal surgical approach.