颈段食管癌挽救性切除的核心技术:从全喉下咽联合切除到纵隔气管造口  

The core technology of salvage resection of cervical esophageal cancer:from total laryngo-pharyngeal resection to mediastinal tracheostomy

作　　者：李志刚[1] Li Zhigang(Department of Thoracic Surgery,Shanghai Chest Hospital,Shanghai Chest Hospital Affiliated to Shanghai JiaoTong University,Shanghai 200030,China)

机构地区：[1]上海市胸科医院,上海交通大学附属胸科医院胸外科,上海200030

出　　处：《中华消化外科杂志》2022年第1期69-73,共5页Chinese Journal of Digestive Surgery

基　　金：国家重点研发计划(2021YFC2501005)。

摘　　要：颈段食管癌目前初始治疗仍然推荐根治性放化疗,对于治疗失败的患者,需行挽救性肿瘤切除术。由于颈段食管癌与周围重要器官毗邻紧密,同时放疗后会造成局部组织界限更为模糊,对外科治疗提出极大挑战。因此,成功完成该手术需全面掌握全喉、下咽、食管、气管切除和重建等多种外科技术。笔者将阐述肿瘤切除、消化道重建、气道重建、淋巴结清扫等核心问题,供国内同道参考,以提高手术成功率,降低致死性并发症发生率。The current primary treatment of cervical esophageal cancer is still the definitive chemoradiotherapy.Salvage esophagectomy is recommended for patients who have failed the therapy.Cervical esophageal cancer is closely adjacent to the surrounding important organs,and the boundaries of regional tissues become more blurred after radiotherapy,which pose a great challenge to surgical treatment.Successful completion of this operation requires a comprehensive grasp of various surgical techniques such as total larynx,pharynx,esophagus,partial tracheal resection and respective reconstruction.The author introduces several core issues of this operation,such as tumor resection,digestive tract reconstruction,airway reconstruction,and lymph node dissection,in order to provide references for domestic colleagues,improve the success rate of surgery,and reduce the occurrence of fatal complications.

关 键 词：普通外科 食管外科 食管肿瘤 颈段 纵隔气管造口 

分 类 号：R735.1[医药卫生—肿瘤]