食管次全切除颈部食管斜切口与胃不同平面分层吻合术  

Analysis of 100 cases with demixing anastomosis of smotach and esophagus slanting resected in cervical part

作　　者：周海波[1] 夏旭[1] 

机构地区：[1]暨南大学医学院第五附属医院,广东清远511500

出　　处：《中国现代医学杂志》2005年第17期2652-2654,共3页China Journal of Modern Medicine

摘　　要：目的探讨减少食管癌手术颈部食管胃吻合口漏、吻合口狭窄和食管残留癌组织的发生率及避免致命的胸内吻合口漏的一种吻合技术。方法食管次全切;颈部食管切除采用斜切口,使食管两端距离达3.5￣4.0cm;食管胃采取黏膜层和浆肌层分层吻合。结果食管癌100例,其中上段食管癌10例、中段79例、中下段11例。早期严重并发症为吻合口瘘4例(4%),残端残留癌组织2例(2%),呼吸功能不全5例(5%),急性心功能不全4例(4%)。术后30d内死亡2例(2%),其中急性心功能衰竭1例,呼吸衰竭1例。结论食管斜切口与胃分层吻合技术能有效地防止术后吻合口瘘及吻合口狭窄的发生。[Objective] To probe into the technology of treating esophageal cancer： To reduce the incidence of anastomotic leakage and stenosis; To reduce remaining tumor tissue in esphagus; To prevent lethal thoracis anastomotic leakage. [Methods] Esophagus sub-resection; Adopt slanting esophagectomy in cervical part and make the distance within 3.5cm～4cm between the incision; Adopt delaminatin anastomosis for mucosa layer and muscle layer in esophagus. [Result] 100 esophageal cancer were treated by this methods. Including 10 cases of superior segment esophageal cancer, 76 cases of middle segment and 11 cases of middle-lower segment esophageal cancer. The early serious complications with 4 cases anastomotic leakage（4%）. 5 cases respiratory insufficiency （5%）, 4 cases acute cardiac insuflqciency （4%）, 2 cases remaining tumor tissue in esophagus（2%）, 2 death in 30 days after the operation, one was acute heart failure , one was respiratory failure. [Conclusion] The slanting esophagectomy in cervical part and demixed anastomosis of esophagus and smotach can reduce the incidence of anastomotic leakage and anastomotic. It also can reduce the occurrence rate of remaining tumor in esophagus and prevent thoracis anastomotic leakage. stenosis and as the postoperative complications from occurring effectively.

关 键 词：食管次全切 食管斜切口 颈部 食管胃吻合 不同平面 

分 类 号：R655.4[医药卫生—外科学]