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目的:探讨食管癌的手术方式及常见并发症的防治。方法:采用左进胸、左颈两切口行食管癌切除、胃食管左颈部吻合术治疗食管癌683例。结果:术后痊愈出院678例,围手术期死亡5例,术后发生颈部吻合口瘘16例(占2.34%),吻合口狭窄9例(占1.32%),肺部并发症12例(占1.75%),心血管系统并发症27例(占3.95%),乳糜胸7例(占1.02%),喉返神经损伤6例(占0.87%),胸腔出血2例(占0.29%)。结论:左进胸、左颈两切口食管癌切除术具有切除彻底、减小创伤、并发症少、病死率低等优点,是比较理想的手术方式。
Objective: To investigate the surgical methods and common complications of esophageal cancer. Methods: 683 cases of esophageal cancer were treated with esophageal cancer resection and gastroesophageal left cervical anastomosis using two incisions of left chest and left neck. Results: 678 cases were cured and discharged after surgery. Five patients died during the perioperative period. There were 16 cases of anastomotic neck fistula (2.34%), 9 cases of anastomotic stenosis (1.32%), and 12 cases of pulmonary complications. Accounted for 1.75%), cardiovascular complications in 27 cases (3.95%), chylothorax in 7 cases (1.02%), recurrent laryngeal nerve injury in 6 cases (0.87%), and chest hemorrhage in 2 cases (0.29%). Conclusion: Left thoracic and left cervical incision esophagectomy has the advantages of thorough resection, less trauma, fewer complications, and low mortality. It is an ideal surgical method.