摘要
目的探讨经右胸、腹二切口行食管癌切除术式的应用。方法经右胸、上腹正中二切口行食管癌切除胸顶食管胃底端侧吻合手术34例,其中胸上段8例,胸中段癌22例,胸下段癌4例;均用吻合器在胸腔内吻合,其中8例在超胸顶吻合。结果手术切除率为100%,其中根治性切除30例,姑息性切除4例,无手术死亡病例、无吻合口瘘及其他严重并发症发生,吻合口狭窄1例,术后40 d分次行食管扩张后临床症状好转。结论经右胸、上腹正中二切口行食管癌切除胸顶食管胃底端侧吻合手术,提高肿瘤切除率,充分清扫胸、腹腔淋巴结,对呼吸功能影响小,肺部并发症少,吻合口瘘发生率低,术后恢复快。
Objective To evaluate the clinical effects of surgical treatment by right posterior thoracotomy,ventrotomy and right upper mediastinum anastomosis for patients with thoracic esophageal carcinoma.Methods 34 patients with esophageal carcinoma of the thoracic segment underwent a radical esophagectomy and a two-incision lymphadenectomy by right posterior thoracotomy and upper middle laparotomy were selected.Stapler was used to perform the anastomoses inside the thoracic cavity,including 8 cases of super-cupula pleurae anastomosis.Results The rate of surgical resection was 100%,including radical resection 30 cases,palliative resection 4 cases.There was no postoperative death,nor stomas fistula occurred,and no serious complications occurred in this group.Stomas stricture 1 man-time,and through persistent repeating pneumatic dilation in the period of 40d post operation,clinical symptom improved.Conclusion Esophagectomy by right thoracotomy and laparotomy is a safe and effective procedure,which enhances the resection rate of tumours,thoroughly scavenging thoracic cavity and abdominal cavity lymphaden,little affecting respiratory function,little pulmonary complications,lower rate of stomas fistula and quickly postoperative recovery.
出处
《安徽医学》
2011年第3期300-301,共2页
Anhui Medical Journal
关键词
二切口
食管肿瘤
胸外科手术
吻合术
Two incision
Esophageal neoplasms
Thoracic surgical procedures
Anastomosis
