Orringer M B
Ann Thorac Surg. 1984 Aug;38(2):128-32. doi: 10.1016/s0003-4975(10)62219-9.
Transhiatal esophagectomy without thoracotomy has been utilized in 200 patients: 57 with benign disease and 143 with carcinomas at various levels of the esophagus (35 pharyngeal or cervicothoracic, 7 upper third, 47 middle third, and 54 distal third). Stomach has been used to replace the esophagus in 93% of patients undergoing single-stage esophagectomy and reconstruction, and colon has been used in 7%. Among patients with intrathoracic esophageal carcinomas, intraoperative blood loss averaged 1,000 ml, and the hospital mortality was 6%. No patient in the entire series has required a thoracotomy for control of bleeding, either during the esophagectomy or postoperatively. This report reviews the technical maneuvers that my collegues and I have found useful in performing transhiatal esophagectomy without thoracotomy.
不开胸经裂孔食管切除术已应用于200例患者：57例患有良性疾病，143例患有食管各段癌（35例为咽或颈胸段、7例为上段、47例为中段、54例为下段）。在接受一期食管切除重建的患者中，93%使用胃替代食管，7%使用结肠。在胸段食管癌患者中，术中平均失血量为1000毫升，医院死亡率为6%。整个系列中没有患者在食管切除术中或术后需要开胸控制出血。本报告回顾了我和我的同事们发现在进行不开胸经裂孔食管切除术时有用的技术操作。
