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对于贲门、食管癌的手术,除了肿瘤所处部位需要有足够的切除范围以外,区域淋巴结清除亦至关重要,同时还要便于消化道的重建。因此在选择手术切口时必须考虑到这三个要素。我科近年来对贲门癌及各段食管癌的传统手术切口作了一些改进。现介绍我们的粗浅经验供同道参考。1 贲门癌传统的贲门癌切口是单纯经腹或胸腹联合或左胸第七肋间/床后外侧切口。三者各有其优缺点:单纯腹部切口创伤较小,腹部显露良好,便于腹部淋巴结清扫,但食管下段淋巴结不易清除。有资料表明,贲门癌下胸部淋巴结转移率达9%,故不能忽略该组淋巴结的清扫。而且单纯腹部切口往往
For surgery of cardiac and esophageal cancer, in addition to the need for adequate resection of the tumor site, regional lymph node clearance is also crucial, but also to facilitate the reconstruction of the digestive tract. Therefore, these three factors must be taken into consideration when selecting surgical incisions. In recent years, our department has made some improvements to the traditional surgical incision of cardiac cancer and various esophageal cancers. Now introduce our shallow experience for reference. 1 Cardia cancer The traditional cardiac cancer incision is a simple transabdominal or thoracoabdominal joint or a seventh intercostal space / posterolateral incision in the left chest. Each has its own advantages and disadvantages: simple abdominal wounds are less traumatic and the abdomen is well exposed, facilitating abdominal lymph node dissection, but the lower esophageal lymph nodes are not easily removed. According to statistics, the rate of lymph node metastasis of the cardiac cancer is 9%, so the lymph node dissection must not be neglected. And simple abdominal incision often