Toty L, Roche J Y, Hertzog P, Maisse P, Kunlin A, Bakdach H, Morand L
Nouv Presse Med. 1978 Dec;7(45):4131-2, 4137.
During surgery for carcinoma of the oesophagus, the authors emphasise the need for selective intubation using a Carlens tube, of avoiding damage to the diaphragm and the phrenic nerve at all levels, and of draining the hemithorax involved in the operation by three drains: anterior and posterior thoracic and madiastino-abdominal. These precautions reduce post-operative difficulties, justifiy excision surgery for carcinoma of the oesophagus, and to a certain extent make it possible to reduce the contraindications, in particular in the presence of tracheo-bronchial spread. Amongst 107 patients undergoing surgery, in whom there was a risk of respiratory insufficiency in one quarter, surgery (sometimes with extension of the excision: one case in four) was associated with an operative and post-operative mortality of 18%.
在食管癌手术过程中，作者强调需要使用卡伦斯管进行选择性插管，避免在各个层面损伤膈肌和膈神经，并通过三根引流管对手术涉及的半侧胸腔进行引流：前胸、后胸及纵隔-腹部引流。这些预防措施可减少术后困难，证明食管癌切除手术的合理性，并在一定程度上能够减少禁忌证，尤其是在存在气管支气管扩散的情况下。在107例接受手术的患者中，四分之一存在呼吸功能不全风险，手术（有时扩大切除范围：四例中有一例）的手术及术后死亡率为18%。
