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1985~1995年共为121例食管癌患者施行了外科手术,其中食管切除术100例,转流术12例,单纯探查9例。切除组中食管次全切除、胃(83/100)或结肠(2/100)_残食管颈部吻合术85例;食管部分切除、食管胃胸内吻合15例(弓上7例、弓下8例)。82%(7/85)伴发颈部吻合口瘘,均行保守治疗治愈。15例胸内吻合者术后均有消化道症状,而颈部吻合者只有247%(21/85)有消化道症状。作者认为:食管次全切除、颈部食管重建更符合肿瘤广泛切除的治疗原则,也接近食管的生理功能与解剖要求,减轻了术后以反流为主的消化道症状。手术操作方便,便于处理与吻合口有关的并发症。
From 1985 to 1995, 121 cases of esophageal cancer patients underwent surgery, including 100 cases of esophagectomy, 12 cases of bypass surgery, and 9 cases of exploration. Esophageal subtotal resection in the resection group, 85 (85/100) or colon (2/100) _ residual esophageal neck anastomosis in 85 cases; esophageal partial resection, esophagogastric intrathoracic anastomosis in 15 cases (7 in the arch, under the arch 8 cases). 8 2% (7/85) with anastomotic neck fistula were treated with conservative treatment. Fifteen cases of intrathoracic anastomosis had gastrointestinal symptoms postoperatively, whereas only 24.7% (21/85) had gastrointestinal symptoms in the neck anastomosis. The author believes that: esophageal subtotal resection, cervical esophageal reconstruction is more consistent with the principle of extensive resection of the tumor, but also close to the physiological function of the esophagus and anatomical requirements, reduce the post-operative reflux-based gastrointestinal symptoms. The operation is convenient and easy to deal with the complications related to anastomosis.