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1、左胸左頸經(jīng)食管床胃■食管頸部吻合術(shù)治療食管癌作者：王雪，張靜【關(guān)鍵詞】食管腫瘤;吻合術(shù)，外科;食管次全切除術(shù)【摘要】冃的探討左胸左頸經(jīng)食管床胃■食管頸部吻合術(shù)治療食管癌的應(yīng)用價值。方法1997年12刀?2005年11刀，我們采用左胸左頸經(jīng)食管床胃-食管頸部吻合術(shù)治療食管癌46例，即常規(guī)游離正常及病變的食管，將胃經(jīng)食管床、主動脈弓后上提至頸部行胃-食管吻合。結(jié)果本組病例中，經(jīng)手術(shù)治療順利康復(fù)出院40例，全組無手術(shù)近期死亡病例，切緣無癌殘留。頸部吻合口痿1例;呼吸道急性梗阻1例;術(shù)后呼吸衰竭應(yīng)用呼吸機(jī)治療1例;乳糜胸1例;排空障礙2例，經(jīng)保守治療痊愈。結(jié)論左胸左頸經(jīng)食管床胃■食管頸部吻合術(shù)治療食管
2、癌因游離胃位于主動脈弓后食管床內(nèi)，故有主動脈弓的阻擋作用，在一定程度上可預(yù)防并降低術(shù)后返流性食管炎的發(fā)生，改善患者術(shù)后生活質(zhì)量。避免在胸內(nèi)吻合，防止了食管癌術(shù)后最嚴(yán)重的并發(fā)癥■胸內(nèi)吻合口痿。因此，左胸左頸經(jīng)食管床胃■食管頸部吻合的食管癌根治術(shù)是治療食管癌的一種既安全又能提高生活質(zhì)量的手術(shù)方式，有較高的應(yīng)用價值?！娟P(guān)鍵詞】食管腫瘤;吻合術(shù)，外科;食管次全切除術(shù)TreatmentofesophagealcarcinomawithesophagogastroplastythroughesophagusbedinleftneckWANGXue,ZHANGJing.(DepartmentofThorac
3、icandCardiovascularSurgery,TheThirdHospitalofBengbu,Anhui233000,China)[Abstract]ObjectiveToexploretheapplicationvalueabouttreatmentwithcarcinomaofesophagusesophagogas-troplastyinleftneckthroughesophagusbed.MethodsFromDecember1997toNovember2005,46patientswithcar-cinomaofesophagusweretreatedinthisway.
4、Normalregulationsvisitsweregiventodissociatethenormalandab?normalesophagusandesophagogastroplastywasperformed.Results40patientswerecured.Nocasediedinthenearfuture,andnocancerresiduesremainedinthecuttingedge.Therewasonecaseoffistula,leaseofacuteobstructofbreathingtract,leaseofrespiratorapplicationbec
5、auseofrespiratoryfailure,leaseofchylothoraxand2casesofemp-tydysfunction.ConclusionSincethedissociatedstomachislocatedbehindtheaortabowintheesophagusbed,andtheaortabowhasthecountercheckfunction,thetreatmentcanpreventthepatientsfromdevelopingtherefluxesophagitistoacertaindegreeandimprovethequalityofli
6、feafterthetreatment.Anastomosiscanbeavoidedinthechest,sothetreatmentcanpreventpatientsfromdevelopingthemostseriouscomplications-esophagealfistulainsidechest.Therefore,theesophagogastroplastyinleftneckthroughesophagusbedasatreatmentforcarcinomaofesoph-gusisakindofsafetype.Itcanimprovelifequality.Ther
7、eishighervalueofapplication.【Keywords】Esophagealneoplasms;Anastomosis,surgical;Esophagectomy目前，治療食管癌的手術(shù)方式較多，一般采用經(jīng)左胸食管癌切除胸內(nèi)食管■胃弓上吻合術(shù)或頸胸腹三切口食管癌根治術(shù)。為提高手術(shù)療效，改善患者術(shù)后生存質(zhì)量，1997年12月?2005年11刀，我們采用胃經(jīng)食管床、主動脈弓后上提至
