上胸骨劈开径路手术治疗胸上段食管癌

摘要

目的 探讨经颈、胸骨上段劈开径路手术治疗胸上段食管癌的临床应用价值.方法 回顾分析了本科手术治疗胸上段食管癌21例患者,应用纵劈上胸骨径路的方法,暴露并予以切除病变的食管,中、下段食管内翻拔脱,胃经食管床提至颈部与食管残端吻合.结果 21例均顺利完成手术,无手术死亡病例.术后发生吻合口瘘1例,肺部感染1例,喉返神经损伤2例.结论 颈胸骨劈开径路手术治疗食管上段癌效果满意.该术式具有避免开胸、创伤小,对患者心肺功能影响较小,显露满意,操作方便的优点,值得推广应用.%Objective To evaluate the value of clinical application to resection esophageal carcinoma in the upper segment of the esophagus through cervicosternal splitting approach. Methods 21 patients suffer esophageal carcinoma of uper segment underwent esophagectomy. Partial cervicosternotomy was performed,the tumor of the upper esophagus were been resected and the segment of the lower thoracic esophagus was stripped by inversion. The stomach was taken up to the neck through the bed of esophagus and anastomoted with cervical esophagus. Results The operation procedure was safety, all patients were survival without hospital death. Post operative complication showed one case anastomotic leakage, one case pulmonary infection, and two cases laryngeal nerve injury. Conclusion It is satisfact to resect upper esophageal carcinoma through cervicosternal splitting approach. The approach will be deserved due to refrain from thoracotomy, smaller injury, smaller influence of cardiorespiratory function, satisfactory exposure, convenient manipulation.