食管癌联合气管部分切除自体心包片修补气管缺治疗的临床观察  

Esophageal cancer joint tracheal resection pericardial repair defects clinical observation of the trachea

作　　者：向家勇[1] 杨晋平[1] 王清海[1] 

机构地区：[1]广元市第一人民医院胸外科,四川广元628017

出　　处：《湖南中医药大学学报》2010年第2期5-6,共2页Journal of Hunan University of Chinese Medicine

摘　　要：目的探讨晚期食管胸上、中段癌外侵至胸段主气管或左、右主支气管膜部、侧壁,术中食管癌联合气管部分膜部及侧壁开窗切除,自体心包片修补气管缺损的方法和治疗效果。方法选择32例患者,食管上段癌选择右胸-颈-腹三切口联合胸段气管侧壁及膜部窗形切除,自体心包片气管膜部及侧壁修补,食管胃颈部吻合术;胸中段食管癌经左胸后外侧切口或右胸-腹二切口,联合左或右侧主支气管膜部、侧壁开窗切除,自体游离心包补片气管修补术,食管胃胸内吻合术。结果本组32例病人出现4例支气管轻度狭窄;7例气管壁缺损心包片修补周围肉芽肿形成;术中左侧喉返神经损伤致声音嘶哑7例,右侧喉返神经损伤致声音嘶哑2例;6例术后发生咳痰困难,经纤支镜吸痰5例及气管切开吸痰1例;痊愈出院。结论食管癌浸润气管膜部及侧壁联合气管部分切除自体心包片气管缺损修补手术治疗,可明显提高晚期食管癌的切除率和远期生存率,明显改善生活质量,减少或避免食管-气管瘘发生。Objective To investigate the advanced esophageal cancer breasts, and the middle period of the trachea and chest or left and right mainstem membrane, wall, and esophageal joint tracheal part of wall and window film, free autologous perieardial slice extubated defect repair therapeutic effect. Methods 32 patients, esophageal cancer, select the upper right chest - neck - three incision abdominal wall and thoracic tracheal membranous window-shaped excision, autologous pericardial patches and the membranous tracheal wall repair, cervical esophagogastric anastomosis; chest mid- esophagus by the posterior lateral left chest or right chest incision - 2 abdominal incision, the joint left or the right main bronchus membranous, lateral fenestration excision, autologous free pericardial patch repair the trachea, esophagus and stomach intrathoracic anastomosis. Results 26 patients without tracheal fistula, 3 cases of tracheal stenosis, 4 cases mild, sputum by bronchoscopy sucking phlegm, motality. Conclusion combined resection, esophageal trachea can obviously increase the resection and long-term surial esophageal fistula, avoid esophageal - tracheal.

关 键 词：食管癌 气管 心包 胸外科手术 

分 类 号：R655.4[医药卫生—外科学]