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目的 :研究经单一右胸入路行跨主动脉弓的食管癌切除术的可行性。方法 :对25例中晚期食管癌患者采用经右胸后外侧切口入胸 ,将胃向上拖出膈裂孔 ,行食管胃胸顶吻合术。结果 :切除率达100% ,其中24例两切端无癌残留 ,病灶旁淋巴结癌转移10例 ;术后吻合口瘘1例 ,肺部感染4例 ;术中胃左血管滑脱1例 ;2例生存期8月 ,8例生存期3年 ,7例生存期4年 ,其余8例存活5年以上。结论 :单一右胸入路适用于中晚期跨主动脉弓的食管癌切除术 ,尤其是对年老体弱和肺功能较差的患者 ,有临床实用价值。
Objective: To study the feasibility of trans-aortic arch esophageal resection via single right chest approach. Methods: Twenty-five patients with advanced esophageal cancer were enrolled in the thoracotomy through the posterolateral thoracotomy, the stomach was pulled up from the diaphragm hole, and esophagogastric anastomosis was performed. Results: The resection rate was 100%, of which 24 cases had no residual tumor at the two ends and 10 cases had metastatic lymph nodes adjacent to the lesion. One case had anastomotic fistula, 4 cases had lung infection, 1 case had left gastric vessel spasm in operation, 2 cases Survival in August, 8 cases of 3 years of survival, 7 cases of survival of 4 years, the remaining 8 cases survived more than 5 years. Conclusion: The single right thoracic approach is suitable for esophageal resection of middle and late trans-aortic arch, especially for patients with frailty and poor pulmonary function.