左胸左颈经食管床胃食管颈部吻合术治疗食管癌

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1、左胸左颈经食管床胃■食管颈部吻合术治疗食管癌作者：王雪，张静【关键词】食管肿瘤;吻合术，外科;食管次全切除术【摘要】冃的探讨左胸左颈经食管床胃■食管颈部吻合术治疗食管癌的应用价值。方法1997年12刀〜2005年11刀，我们采用左胸左颈经食管床胃-食管颈部吻合术治疗食管癌46例，即常规游离正常及病变的食管，将胃经食管床、主动脉弓后上提至颈部行胃-食管吻合。结果本组病例中，经手术治疗顺利康复出院40例，全组无手术近期死亡病例，切缘无癌残留。颈部吻合口痿1例;呼吸道急性梗阻1例;术后呼吸衰竭应用呼吸机治疗1例;乳糜胸1例;排空障碍2例，经保守治疗痊愈。结论左胸左颈经食管床胃■食管颈部吻合术治疗食管

2、癌因游离胃位于主动脉弓后食管床内，故有主动脉弓的阻挡作用，在一定程度上可预防并降低术后返流性食管炎的发生，改善患者术后生活质量。避免在胸内吻合，防止了食管癌术后最严重的并发症■胸内吻合口痿。因此，左胸左颈经食管床胃■食管颈部吻合的食管癌根治术是治疗食管癌的一种既安全又能提高生活质量的手术方式，有较高的应用价值。【关键词】食管肿瘤;吻合术，外科;食管次全切除术TreatmentofesophagealcarcinomawithesophagogastroplastythroughesophagusbedinleftneckWANGXue,ZHANGJing.(DepartmentofThorac

3、icandCardiovascularSurgery,TheThirdHospitalofBengbu,Anhui233000,China)[Abstract]ObjectiveToexploretheapplicationvalueabouttreatmentwithcarcinomaofesophagusesophagogas-troplastyinleftneckthroughesophagusbed.MethodsFromDecember1997toNovember2005,46patientswithcar-cinomaofesophagusweretreatedinthisway.

4、Normalregulationsvisitsweregiventodissociatethenormalandab・normalesophagusandesophagogastroplastywasperformed.Results40patientswerecured.Nocasediedinthenearfuture,andnocancerresiduesremainedinthecuttingedge.Therewasonecaseoffistula,leaseofacuteobstructofbreathingtract,leaseofrespiratorapplicationbec

5、auseofrespiratoryfailure,leaseofchylothoraxand2casesofemp-tydysfunction.ConclusionSincethedissociatedstomachislocatedbehindtheaortabowintheesophagusbed,andtheaortabowhasthecountercheckfunction,thetreatmentcanpreventthepatientsfromdevelopingtherefluxesophagitistoacertaindegreeandimprovethequalityofli

6、feafterthetreatment.Anastomosiscanbeavoidedinthechest,sothetreatmentcanpreventpatientsfromdevelopingthemostseriouscomplications-esophagealfistulainsidechest.Therefore,theesophagogastroplastyinleftneckthroughesophagusbedasatreatmentforcarcinomaofesoph-gusisakindofsafetype.Itcanimprovelifequality.Ther

7、eishighervalueofapplication.【Keywords】Esophagealneoplasms;Anastomosis,surgical;Esophagectomy目前，治疗食管癌的手术方式较多，一般采用经左胸食管癌切除胸内食管■胃弓上吻合术或颈胸腹三切口食管癌根治术。为提高手术疗效，改善患者术后生存质量，1997年12月〜2005年11刀，我们采用胃经食管床、主动脉弓后上提至