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目的：探讨单体位左胸左颈两切口的手术方式在外科治疗食管上段癌中的应用效果。方法：选择2008 年1 月至2012 年4 月间我院收治的食管上段癌患者49 例，根据手术方法分为研究组（n=19）和对照组（n=30），研究组行单体位左胸左颈两切口管型吻合器治疗，对照组行传统颈、胸、腹三切口方法治疗。观察两组手术时间、术中出血量、清扫淋巴结数、术后引流量和术后并发症等。结果：研究组手术时间显著短于对照组，术中出血量和术后引流量显著低于对照组（P<0.05）。两组清扫淋巴结数比较无统计学差异（P>0.05）。两组患者均全部治愈出院，研究组肺不张、反流性食管炎、吻合口瘘、吻合口狭窄等发生率显著低于对照组（P<0.05）。结论：单体位左胸左颈两切口管型吻合器治疗食管上段癌安全，可靠，省时易行，是一种较好的手术方式，值得推广。

英文摘要:

Objective:To investigate the effect of single position left cervico-thoracic two incisions in the treatment of upper esophageal carcinoma.Methods:49 patients with upper esophageal carcinoma from January 2008 to April 2012 in our hospital were selected and divided into the study group (n=19) and control group (n=30) according to the operation styles, the study group received single position left cervico-thoracic two incisions tube type anastomat treatment, while the control group underwent conventional neck-chest-abdomen three incisions method. The operation time, bleeding volume, number of lymph node dissection, postoperative drainage and postoperative complications were observed.Results:The operation time of the study group was significantly shorter than that in the control group, the amount of intraoperative bleeding and postoperative drainage volume was significantly lower than that of the control group(P<0.05). No significant differences were seen in number of lymph node dissection between the two groups (P>0.05). Two groups of patients were all cured, the incidences of pulmonary atelectasis, reflux esophagitis, anastomotic leakage and anastomotic stenosis in study group were significantly lower than those in the control group(P<0.05).Conclusion:Single position left cervico-thoracic two incision tube type anastomat is safe, time-saving and easy to operate in the treatment of upper esophageal cancer, it is a better operation mode and is worthy of promotion.

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