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目的探讨主动脉血管旁路转流术在食管癌肿瘤侵及主动脉时手术治疗中的临床应用。方法2012年2月至2013年3月,我院3例食管癌侵及主动脉病例,术前胸部CT检查显示食管肿瘤侵及降主动脉,选择左侧胸后外侧切口;术中在肿瘤侵及主动脉部位上下两端,临时架接“血管桥”达到血管旁路转流的目的,再阻断受侵主动脉部位上下两端,进行充分彻底的肿瘤解剖,发生主动脉损伤或缺损,予以修补。结果肿瘤解剖彻底损伤的主动脉血管外膜及中层,予以修补,术后顺利恢复。术后随访7~20个月复查无肿瘤复发及转移。结论主动脉血管旁路转流技术操作程序简单,安全可靠,创伤小,不增加额外的人员与设备(体外循环相关)增加了食管肿瘤的切除率。
Objective To investigate the clinical application of aortic bypass shunt in the surgical treatment of esophageal cancer invading the aorta. Methods From February 2012 to March 2013, 3 cases of esophageal cancer invading the aorta were included in our hospital. CT scan of the thoracic esophagus showed that the esophageal tumor invaded the descending aorta and the left thoracic posterolateral incision was selected. During the operation, And the upper and lower ends of the aorta site, temporary access “vascular bridge ” to achieve the purpose of bypassing the blood vessels, and then blocking the upper and lower ends of the affected aorta, thorough and complete tumor dissection, the occurrence of aortic injury or Defect, to be repaired. The results of complete destruction of the tumor anatomy of the aortic vascular adventitia and middle, to be repaired, postoperative recovery. All the patients were followed up for 7-20 months without tumor recurrence and metastasis. Conclusions The procedure of aortic bypass is simple, safe and reliable, with less trauma and extra resection (associated with cardiopulmonary bypass), which increases the resection rate of esophageal tumors.