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目的探讨经上腹右胸两切口施行食管中下段癌根治术的临床效果。方法 58例食管中下段癌患者,患者均采取经上腹右胸两切口施行食管中下段癌根治术,观察患者手术切除情况、平均手术时间、平均术中失血量、切口感染情况、严重并发症(吻合口瘘、喉返神经损伤)发生情况,围手术期因术后吻合口瘘合并呼吸衰竭而死亡者,腹腔淋巴结清除数及转移数、胸腔淋巴结清除数及转移数、两野淋巴结转移情况、术后胸腔引流管保留时间、术后进食时间、术后5年患者生存情况。结果 58例患者的切除率为100.00%(58/58);平均手术时间为(4.37±1.52)h;平均术中失血量为(208.59±31.58)ml;切口感染率为5.17%(3/58);严重并发症(吻合口瘘1例、喉返神经损伤1例)发生率为3.45%;围手术期因术后吻合口瘘合并呼吸衰竭而死亡者1例,其发生率为1.72%;腹腔淋巴结清除数平均为(9.2±1.1)枚,转移数为(2.1±0.9)枚;胸腔淋巴结清除数平均为(10.4±1.2)枚,转移数为(2.3±1.1)枚;两野淋巴结转移率为22.41%(13/58);术后胸腔引流管保留时间为(9.87±5.21)d;术后进食时间平均为(10.33±3.35)d;患者术后5年生存者32例,5年生存率为55.17%。结论经上腹右胸两切口施行食管中下段癌根治术是一种方便、安全、切除率高及根治效果良好的可优先推荐的手术方式。
Objective To investigate the clinical effect of transrectal right thoracic incision on the middle and lower esophageal cancer radical mastectomy. Methods 58 cases of lower esophageal cancer patients and patients were taken through the lower abdomen right chest two incisions in the lower esophageal cancer radical operation to observe the surgical resection, the average operation time, mean blood loss, incision infection, serious complications (Anastomotic fistula and recurrent laryngeal nerve injury), perioperative deaths due to postoperative anastomotic leakage and respiratory failure, number and number of lymph node metastases, number and number of lymphadenectasis and two-node lymph node metastasis , Postoperative chest drainage tube retention time, postoperative eating time, 5 years after the patient’s survival. Results The resection rate of the 58 patients was 100.00% (58/58). The average operation time was (4.37 ± 1.52) h. The average blood loss was (208.59 ± 31.58) ml. The incision infection rate was 5.17% (3/58) ); Serious complications (anastomotic fistula in 1 case, recurrent laryngeal nerve injury in 1 case) the incidence was 3.45%; perioperative postoperative anastomotic leakage combined with respiratory failure and death in 1 case, the incidence was 1.72%; The average number of lymph node dissection in peritoneal cavity was (9.2 ± 1.1) mm and the number of metastasis was (2.1 ± 0.9). The average number of lymph node dissection was (10.4 ± 1.2) and the number of metastasis was (2.3 ± 1.1) The average duration of postoperative ingestion was (10.33 ± 3.35) d. The postoperative 5-year survival rate was 32 and the average follow-up time was 5 years Survival rate was 55.17%. Conclusions The radical operation of middle and lower esophageal cancer with two incisions of the right upper chest and right incision is a convenient and safe method with high excision rate and good curative effect.