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目的回顾总结359例食管癌的外科治疗经验。方法对所有病人的临床资料进行回顾性分析。结果359例病人中,281例接受了根治性切除,59例行姑息行手术,12例接受了食管胃旁路手术,7例仅仅进行了剖胸探查术。6例术后病理证实为残端阳性,33例术后发生了并发症,其中12例术后死亡。结论考虑到食管癌特殊的生物学特性,即便对那些晚期肿瘤我们也应该对其外科治疗持积极态度,术中尽可能多地切除食管和行冰冻切片检查有望避免残端阳性。临床需要采取各种措施来减少术后并发症,其中积极的术前准备有助于减少手术风险,机械吻合时采取一些特殊的手术技巧可望降低相关的并发症。
Objective To review the experience of surgical treatment of 359 cases of esophageal cancer. Methods The clinical data of all patients were retrospectively analyzed. Results Of 359 patients, 281 underwent radical resection, 59 underwent palliative surgery, 12 underwent esophageal gastric bypass surgery, and 7 underwent thoracotomy alone. Postoperative pathology was confirmed as stump-positive in 6 cases, and complication occurred in 33 cases, of which 12 died after operation. CONCLUSIONS Given the specific biological characteristics of esophageal cancer, we should also take a positive attitude toward surgical treatment of those advanced tumors. Intraoperative esophageal resection and frozen-section biopsy should be expected to avoid stump-positive results. Clinical needs to take various measures to reduce postoperative complications, of which positive preoperative preparation can help reduce the risk of surgery, mechanical anastomosis with some special surgical techniques is expected to reduce the associated complications.