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目的:探讨手术治疗食管癌穿孔的理想手术方法及围术期治疗特点。方法:对36例食管癌穿孔(其中穿入右肺14例,穿入纵隔17例,穿入气管5例)患者进行手术治疗。开胸手术34例,其中右胸三切口术式16例,分期手术15例。34例中经胸骨后间隙胃或结肠代食管26例。结果:31例患者获得手术成功,手术死亡3例。术后随访3～72个月,其中生存7～12个月15例,24个月2例,72个月1例,疗效较为满意。结论:手术治疗食管癌穿孔效果较为明显,优于一般保守治疗。手术方式以右胸三切口术式(胸骨后胃或结肠代食管)或分期手术为佳。
Objective: To investigate the ideal operation method and perioperative treatment characteristics of surgical treatment of perforation of esophageal cancer. Methods: Thirty-six patients with perforation of esophageal carcinoma (including 14 penetrating into the right lung, 17 penetrating the mediastinum and 5 penetrating the trachea) underwent surgical treatment. Thoracotomy in 34 cases, including the right thoracotomy incision in 16 cases, staging surgery in 15 cases. Twenty-four of the 34 patients underwent esophageal or esophageal replacement of the esophagus through the space behind the sternum. Results: 31 patients were successful in surgery and 3 died of surgery. The patients were followed up for 3 to 72 months. Among them, 15 cases survived 7 to 12 months, 2 cases 24 months and 1 case 72 months. The curative effect was satisfactory. Conclusion: Surgical treatment of esophageal cancer perforation is more obvious, better than the average conservative treatment. Surgical approach to the right thoracotomy (sternum or colon on behalf of the esophagus) or staging surgery is better.