Shimakawa Takeshi, Naritaka Yoshihiko, Asaka Shinichi, Miyazawa Miki, Murayama Minoru, Yamaguchi Kentaro, Usui Takebumi, Yokomizo Hajime, Yoshimatsu Kazuhiko, Shiozawa Shunichi, Katsube Takao
Department of Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan
Department of Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.
Anticancer Res. 2018 Apr;38(4):2323-2327. doi: 10.21873/anticanres.12477.
Three-field lymph node dissection is now performed in operations for advanced thoracic esophageal cancer, with an associated improvement in outcomes. However, reconstructive surgery following resection of the esophagus is frequently associated with the occurrence of anastomotic leakage. Once it occurs, major problems can arise such as decreased quality of life, protracted hospitalization, or even death. This is why there has been a large number of innovations in and modifications to reconstructive surgery. The standard procedures in our Department for advanced thoracic esophageal cancer are subtotal esophagectomy and three-field lymph node dissection. The thin gastric tube along the greater curvature is used as the reconstructed organ in reconstructive surgery, performing a cervical esophagogastrostomy. Innovations have been made to reconstructive surgery in order to prevent anastomotic leakage. This procedure markedly reduces anastomotic leakage, and also reduces anastomotic stricture, which likely makes it an extremely useful procedure that any surgeon can perform.
目前，在进展期胸段食管癌手术中会进行三野淋巴结清扫，其可改善预后。然而，食管切除术后的重建手术常伴有吻合口漏的发生。一旦发生吻合口漏，就可能出现诸如生活质量下降、住院时间延长甚至死亡等重大问题。这就是重建手术出现大量创新和改进的原因。我们科室治疗进展期胸段食管癌的标准术式是食管次全切除术和三野淋巴结清扫。重建手术中采用沿胃大弯的细胃管作为重建器官，行颈部食管胃吻合术。为预防吻合口漏，重建手术已有所创新。该术式显著减少了吻合口漏，还降低了吻合口狭窄，这可能使其成为任何外科医生都能实施的极其有用的术式。
