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目的对左侧开胸保留食管膈肌裂孔的手术方式做进一步研究。方法将180例左侧开胸食管癌手术患者随机分为两组,其中105例采用常规左开胸方式,开胸游离食管后,再开膈游离胃(常规组)。其余75例采用保留食管膈肌裂孔的方式游离下段食管和胃(对照组)。结果通过比较两种手术方式,对照组患者手术时间、术中出血量、术后住院无数和呼吸衰竭发生率优于常规组,差异具有统计学意义(P<0.05)。两组患者术后胃排空障碍、清扫淋巴结个数、复查5年生存率比较,差异无统计学意义(P>0.05)。结论保留食管膈肌裂孔的左侧开胸食管癌手术,是可行的,手术不增加手术难度,体型较瘦的患者手术优势较明显。
Objective To further study the surgical method of preserving the open of the thoracotomy for the diaphragm of the esophagus. Methods 180 cases of left thoracic esophageal cancer surgery were randomly divided into two groups, of which 105 cases were treated by conventional left thoracotomy. The remaining 75 cases of esophageal and gastric lower esophageal and gastric reservation using the way of retaining the diaphragm of the esophagus (control group). Results By comparing the two operation methods, the operation time, intraoperative blood loss, hospitalized countless number of patients and respiratory failure rate in the control group were significantly better than those in the conventional group (P <0.05). There was no significant difference between the two groups in postoperative gastric emptying disorder, the number of lymph node dissection, and the 5-year review of survival rate (P> 0.05). Conclusion It is feasible to keep esophageal diaphragm open on the left thoracotomy for esophageal cancer. The operation does not increase the operation difficulty, and the patients with thinner body have obvious advantages in operation.