复杂食管癌的外科治疗进展

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1、［摘要］复杂食管癌是指切除困难和/或切除后消化道重建困难常规手术无法治疗的食管癌。本文将复杂食管癌分为三类：部位复杂，颈段食管癌；病变复杂，双源癌（食管癌合并胃癌）；病史复杂，残胃食管癌。复杂食管癌患者的手术是一种跨学科的治疗方法，手术涉及喉、咽、食管和胃肠的切除与功能重建，与普通食管癌相比，复杂食管癌具有临床少见、手术操作复杂、治疗经验相对不足等特点。手术医生根据各自的经验选择不同的手术方式，每种手术方式都有各自的优缺点，至今尚无统一的手术方式，对其外科治疗无法开展前瞻性的临床研宄，只能根据少数的个例治疗经验和个体病变寻求最佳各

2、治疗方案。本文对三类复杂食管癌的常见手术方式的优缺点及术后并发症情况分别进行阐述，总结各种手术经验，以供临床参考。［关键词］复杂食管癌；消化道重建；颈段食管癌;双源癌；残胃食管癌［中图分类号］R735.1［文献标识码］A［文章编号］1674-4721(2016)10(c)-0060-04[Abstract]Complexesophagealcancersaredefinedaswhataredifficulttoberesected,reconstructedorcuredbytraditionaloperationmethods

3、.Inthispaper,complexesophagealcancersaredividedintothreecategories：thoselocatedincomplexsiteandcervicalesophaguscarcinoma,thosewithcomplicatedlesionsandconcurrentgastrointestinalcancers，thosewithcomplicatedhistoryandesophagealcancerafterdistalgastrectomy.Thesurgerymet

4、hodsofcomplexesophagealcancersareinterdisciplinarytreatments,involvingthethroat,pharynx，esophagus，andgastrointestinalsurgeryresectionandfunctionreconstruction.Comparedwithconventionalesophagealcancers，complexesophagealcancershaveitscharacteristics，suchasrarityinclinic

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6、edout.Thebesttherapeuticschedulescanonlyrelyonexperiencesofsmallcase[Abstract]Complexesophagealcancersaredefinedaswhataredifficulttoberesected,reconstructedorcuredbytraditionaloperationmethods.Inthispaper,complexesophagealcancersaredividedintothreecategories：thoseloca

7、tedincomplexsiteandcervicalesophaguscarcinoma,thosewithcomplicatedlesionsandconcurrentgastrointestinalcancers，thosewithcomplicatedhistoryandesophagealcancerafterdistalgastrectomy.Thesurgerymethodsofcomplexesophagealcancersareinterdisciplinarytreatments,involvingthethr

8、oat,pharynx，esophagus，andgastrointestinalsurgeryresectionandfunctionreconstruction.Comparedwithconventionalesophagealcancers