Barbier P, Müller K, Wagner H, Berchtold R
Schweiz Med Wochenschr Suppl. 1985;19:9-15.
During the period between 1982 and 1984, 25 patients with carcinoma of the esophagus underwent esophageal resection by the technique of blunt transhiatal esophagectomy without thoracotomy. The esophagus was replaced with stomach. The indications for blunt dissection of the esophagus are discussed and the operative technique is described. There was no postoperative mortality. Complications included pulmonary complications (19), anastomotic leak (9), left vocal cord paralysis (5) and stenosis of the cervical anastomosis (7). Postoperative hospitalization averaged 18 days. Following discharge from hospital patients are seen in follow-ups at 3-month intervals for 1 year, then at 6-month intervals. Quality of life is good. In the majority of patients with esophageal carcinoma, the goal of esophagectomy is palliation, not cure. Therefore, long-term prognosis of esophageal carcinoma is poor. Actual survival among the patients is 49% at 12 months, and mean survival 10.2 months. Transhiatal esophagectomy without thoracotomy is a safe procedure and far better tolerated by elderly and debilitated patients than a combined transthoracic and abdominal operation. We believe that this procedure is the treatment of choice for esophageal carcinoma at all levels.
在1982年至1984年期间，25例食管癌患者采用钝性经裂孔食管切除术（不开胸）进行了食管切除。食管用胃替代。讨论了钝性分离食管的适应证并描述了手术技术。术后无死亡病例。并发症包括肺部并发症（19例）、吻合口漏（9例）、左侧声带麻痹（5例）和颈部吻合口狭窄（7例）。术后平均住院时间为18天。出院后，患者在1年内每3个月随访一次，之后每6个月随访一次。生活质量良好。在大多数食管癌患者中，食管切除的目的是缓解症状，而非治愈。因此，食管癌的长期预后较差。患者的实际12个月生存率为49%，平均生存期为10.2个月。不开胸经裂孔食管切除术是一种安全的手术，与经胸和腹部联合手术相比，老年和体弱患者对其耐受性要好得多。我们认为该手术是各级食管癌的首选治疗方法。
