论文部分内容阅读
目的观察胸腹“二切口”胃代食管、右胸顶部食管胃端侧吻合术治疗食管中下段癌的近期疗效,并探讨其临床应用价值。方法采用上腹部正中加右胸后外侧“二切口”术式(Lew is切口),经右胸、胃代食管、右胸顶部食管胃端侧吻合治疗食管中下段癌,观察术后反流、吻合口瘘、吻合口狭窄、切缘阳性及淋巴结清扫情况。结果食管反流3.16%(3/95),术后胸胃胃潴留1.05%(1/95),无吻合口瘘、吻合口狭窄、乳糜胸及切缘阳性发生。结论胸腹“二切口”术式,具有反流率低、胸腹腔相关淋巴结清扫彻底、直视下操作方便等优点,能减少吻合口瘘及乳糜胸的发生率,不切开膈肌,对呼吸功能影响较小,是目前中下段食管癌较理想的术式。
Objective To observe the short-term curative effect of esophageal and esophageal gastric anastomosis on the middle and lower esophageal cancer of the thoracoabdominal “two incisions” and discuss its clinical value. Methods The middle and lower esophageal cancer was treated by the middle upper abdomen and the right lateral thoracotomy (Lewis incision). The right esophagus and stomach on the esophagus and the right esophagus were treated by esophagogastric end-to-side anastomosis. The postoperative reflux, Anastomotic fistula, anastomotic stenosis, positive margins and lymph node dissection. Results Esophageal reflux was 3.16% (3/95). Postoperative thoracic gastric retention was 1.05% (1/95). There was no anastomotic fistula, anastomotic stricture and chylothorax and margins were positive. Conclusion The operation of chest and abdomen “two incisions” has the advantages of low reflux ratio, complete thoracoabdominal and abdominal lymph nodes dissection, easy operation under direct vision, etc. It can reduce the incidence of anastomotic fistula and chylothorax without cutting the diaphragm and respiration Less functional impact, is the lower esophageal cancer surgery is more ideal.