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目的:回顾性总结手术切除的1179例食管癌贲门癌病例,对手术方式和术后并发症的相关性做比较。方法:采用4种开胸入路手术方式。结果:1)右胸腹颈三切口手术157例发生并发症多。2)左胸颈二切口全胃食管床内移植123例,手术简便安全,并发症少。3)左胸主动脉弓上吻合215例,并发症最多。4)左胸主动脉弓下吻合684例,手术简单安全,并发症最少。结论:推荐食管上段癌手术选择右胸腹颈三切口术式,中段癌选左胸颈二切口,下段癌选择主动脉弓下吻合或左颈吻合,尽量少用主动脉弓上吻合。
OBJECTIVE: To retrospectively summarize the 1179 cases of esophageal and cardiac cancer who underwent surgical resection, and to compare the correlation between the surgical approach and postoperative complications. Methods: Four types of thoracotomy were used. Results: 1) There were more complications in the 157 cases of right thoracotomy. 2) Left thoracic two incisions total stomach esophageal bed transplanted in 123 cases, the operation is simple and safe, fewer complications. 3) 215 cases of anastomosis of left aortic arch, the most complications. 4) 684 cases of anastomosis of the left thoracic aorta, surgery is simple and safe, with minimal complications. Conclusions: The right thoracic and abdominal incision cholecystectomy is recommended in the upper esophageal carcinoma, and the left thoracic incision is selected in the middle carcinoma. The inferior segment of the lesion chooses aortic arch anastomosis or left anastomosis, and the aortic arch should be used as little as possible.