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本文报道用非开胸手术治疗8例上段食管癌,取得了良好效果。男性5例,女性3例。年龄自42至58岁。X线表现为髓质型9例、溃疡型和缩窄型各1例。病变长度为3-5.5cm。肿瘤下缘均在主动脉弓上缘以上。均行非开胸食管内翻拔脱术及胃代食管颈部吻合术,病理均为鳞状细胞癌。术后单纯吻合口瘘1例,吻合口瘘伴声音嘶哑1例,声音嘶哑伴误咽2例,无手术死亡。此手术的优点为扩大了手术范围,原心肺功能较差不适合开胸者,可胜任此种手术;手术不切开隔肌,故不影响膈肌功能;又因不开胸故胸腔内环境无变化。出血量一般不超过200m1,我们认为它是治疗上段食管癌的一种比较可行的术式。
This article reported the use of non-thoracotomy surgery in the treatment of 8 cases of upper esophageal cancer, and achieved good results. There were 5 males and 3 females. Age from 42 to 58 years old. The X-ray findings were in 9 cases of medullary type, 1 case of ulceration and 1 case of constriction. The lesion length is 3-5.5cm. The lower edge of the tumor is above the upper edge of the aortic arch. All patients underwent non-thoracotomy esophagectomy and gastroesophageal esophageal neck anastomosis. The pathology was squamous cell carcinoma. After surgery, there was only one case of anastomotic leakage, one case of anastomotic leakage with hoarseness, two cases of hoarseness with accidental pharynx, and no operative death. The advantage of this operation is to expand the scope of surgery, the original poor heart and lung function is not suitable for open chest, can be competent for this kind of surgery; surgery does not cut the diaphragm, it does not affect the diaphragm muscle function; but also because the chest is not open the internal environment of the chest Variety. The amount of bleeding is generally not more than 200m1, and we think it is a more feasible surgical treatment for the upper esophageal cancer.