食管胃颈部单层吻合术治疗食管癌方法探讨

目的探讨食管胃颈部单层吻合术治疗食管癌的方法及疗效。方法回顾分析612例食管癌患者采用左侧开胸胃经食管床、主动脉弓后至颈部行食管胃单层吻合的临床资料。结果根治性切除599例,姑息性切除13例,切除率100%;术后出现颈部吻合口瘘12例,肺不张3例,肺部感染8例,返流性食管炎10例,乳糜胸1例,并发症的发生率为5.7%(35/612),无吻合口狭窄及喉返神经损伤发生。结论颈部单层吻合愈合好,对心肺功能影响小,吻合口瘘及狭窄发生率较低,有利于患者恢复和提高术后生活质量。

A single layer anastomosis in cervical reconstruction of the esophagus with stomach following esophagogastrostomy for the patients with esophageal carcinoma

Objective To approach the effect of a single layer anastomosis during cervical reconstruction of the esophagus with stomach for the patients with esophageal carcinoma following esophagogastrostomy.Methods The clinical data of 612 cases with esophageal carcinoma underwent esophagogastrostomy with cervical a single layer anastomosis to reconstruct the esophagus with stomach were analyzed retrospectively.Results Of 612 cases 599 cases underwent complete resection of the tumor and 13 cases underwent palliative surgery.The over all rate of tumor resection was 100%.There were 12 cases with cervical anastomotic leakage,3 with atelectasis,8 with pneumonia,10 with gastroesophageal reflux and 1 with chylothorax after operation.The overall incidence of the complications was 5.7%.Conclusion The cervical single layer anoastomosis of the esophagus with the stomach following esophagogastrostomy is helpful to enhance healing of the anastomosis,to decrease the rate of the postoperative anastomotic leakage and to improve quality of the postoperative life due to its less operative trauma,excellent exposure and less interfering of the heart and lung functions.