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目的:探讨单体位左胸左颈两切口的手术方式在外科治疗食管上段癌中的应用效果。方法:选择2008年1月至2012年4月间我院收治的食管上段癌患者49例,根据手术方法分为研究组(n=19)和对照组(n=30),研究组行单体位左胸左颈两切口管型吻合器治疗,对照组行传统颈、胸、腹三切口方法治疗。观察两组手术时间、术中出血量、清扫淋巴结数、术后引流量和术后并发症等。结果:研究组手术时间显著短于对照组,术中出血量和术后引流量显著低于对照组(P<0.05)。两组清扫淋巴结数比较无统计学差异(P>0.05)。两组患者均全部治愈出院,研究组肺不张、反流性食管炎、吻合口瘘、吻合口狭窄等发生率显著低于对照组(P<0.05)。结论:单体位左胸左颈两切口管型吻合器治疗食管上段癌安全,可靠,省时易行,是一种较好的手术方式,值得推广。
Objective: To investigate the effect of single surgical operation of left chest and left incision in surgical treatment of upper esophageal cancer. Methods: Forty-nine patients with upper esophageal cancer admitted to our hospital from January 2008 to April 2012 were divided into study group (n = 19) and control group (n = 30) Left thoracolumbar neck incision tube type stapler treatment, the control group underwent traditional neck, thoracic and abdominal incision three methods of treatment. The operation time, intraoperative blood loss, number of lymph nodes, postoperative drainage and postoperative complications were observed. Results: The operation time of the study group was significantly shorter than that of the control group. The amount of bleeding during operation and postoperative drainage were significantly lower than those of the control group (P <0.05). There was no significant difference in the number of lymph nodes between the two groups (P> 0.05). The two groups of patients were cured and discharged. The incidence of atelectasis, reflux esophagitis, anastomotic fistula and anastomotic stricture in the study group was significantly lower than that in the control group (P <0.05). CONCLUSION: Single left thoracolumbar neck incision tube stapler is safe, reliable and time-saving for the treatment of upper esophageal cancer, which is a good surgical method and worthy of popularization.