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目的探讨左胸径路行食管癌切除、弓上食管床机械吻合术的临床效果。方法对1500例中、下段食管癌患者采用标准左胸后外侧切口,胃代食管,食管床弓上机械吻合,吻合位置可达胸顶甚至超胸顶水平。术中常规清扫胸内淋巴结和腹腔淋巴结。结果全组患者手术过程顺利,无吻合失败,均一次击发成功。术后并发症有吻合口瘘、乳糜胸、吻合口狭窄及心肺并发症等,死亡5例。术后病理无1例切缘阳性。结论左胸食管癌切除弓上食管床机械吻合,符合人体的生理解剖,可避免和减少术后并发症,更符合肿瘤的治疗原则,有更好的生活质量。
Objective To investigate the clinical effect of esophagectomy on the left breast pathways and mechanical anastomosis of the esophagus on the arch. Methods One hundred and thirteen cases of middle and lower esophageal cancer patients were treated with standard left thoracotomy, gastric esophagus and esophageal arch with mechanical anastomosis. The anastomosis position reached the level of the chest or even the super-thoracic. Intraoperative routine clearance of intrathoracic lymph nodes and abdominal lymph nodes. Results All patients underwent a successful surgical procedure without any failure. All were successful in one attack. Postoperative complications were anastomotic fistula, chylothorax, anastomotic stricture and cardiopulmonary complications, 5 patients died. No postoperative pathology positive margins. Conclusions The left esophagus resection of the upper esophageal esophageal anastomosis, in line with the physiological anatomy of the human body, to avoid and reduce postoperative complications, more in line with the principles of cancer treatment, have a better quality of life.