Middle esophagus cancer resection

Stage 1.0, stage I, stage II esophageal chest and upper thoracic carcinoma, lower thoracic cancer can be relaxed to stage III, more limited to the cardia cancer, the general condition is good, no surgical contraindications. 2. Esophageal cancer recurrence after radiotherapy, the extent of lesions is not large, no distant metastasis, and good general condition. 3. High esophageal obstruction, no distant metastasis, and general conditions, should actively seek surgical exploration. Unresectable, feasible bypass surgery, supplemented by radiotherapy, chemotherapy and immunotherapy. Treating diseases: esophageal cancer Indication Stage 1.0, stage I, stage II esophageal chest and upper thoracic carcinoma, lower thoracic cancer can be relaxed to stage III; more limited cardia cancer, general condition, no surgical contraindications. 2. Esophageal cancer recurrence after radiotherapy, the extent of lesions is not large, no distant metastasis, and good general condition. 3. High esophageal obstruction, no distant metastasis, and general conditions, should actively seek surgical exploration. Unresectable, feasible bypass surgery, supplemented by radiotherapy, chemotherapy and immunotherapy. Contraindications The age of the body is weak, the vital organs such as the heart and lungs are poor, and the surgery does not restore hope. Preoperative preparation 1. Patients with high esophageal obstruction, wash the esophagus 3 days before surgery. 2. Oral esophageal anti-inflammatory drugs are taken after the hospital. 3. Strengthen nutrition and correct water and electrolyte disorders. 4. Colon transplants are prepared for colon cancer. Surgical procedure 1. Incision: 6th ribbed incision in the posterior aspect of the left chest. 2. The left lower lobe is retracted forward and upward, and the mediastinal pleura is cut longitudinally between the pericardium and the thoracic aorta. 3. Explore the lesion. Pay attention to the location and size of the tumor; whether there is infiltration with the inferior pulmonary vein and the posterior thoracic aorta; or the lymph node metastasis in the mediastinum. Once the tumor has been resectable, the esophageal detachment should be suspended. Cut the diaphragm and explore the presence or absence of metastases in the abdominal organs. 4. If the tumor has no metastasis, continue to dissipate the esophagus up to the aortic arch. The operation should be close to the esophageal wall separation, pay attention to the ligation of the small arteries from the thoracic aorta, the strips should be ligated. Avoid damage to the thoracic duct. When the thoracic duct is stuck to the tumor and cannot be separated, the thoracic duct is ligated and cut off on the upper and lower sides of the tumor. 5. The stomach is free. The door was cut off and the two layers were closed. A rubber sheath is ligated at the esophageal end to reduce contamination in the pleural cavity. 6. The mediastinal pleura was cut longitudinally above the aortic arch, between the spine and the left subclavian artery (ie, the upper esophagus), and the esophagus was freed. 7. Pull down the esophageal traction line. The left finger points the wall of the esophageal duct and extends behind the aortic arch. The esophagus is bluntly separated. The strips that pass through the esophagus should be clamped, cut, and ligated. 8. The esophageal traction line is pulled up from the aortic arch, and then the esophagus is ejected upwards, and the operation must be gentle. If the esophageal tumor is too large, it can be removed first, and then the upper remaining esophagus is pulled to the bow. 9. The stomach is lifted onto the aortic arch, and the end of the esophagus is anastomosed (the same method as before). After the anastomosis is completed, the stomach wall and the posterior chest wall are intermittently fixed by a thin wire. 10. Suture the diaphragm and close the chest. complication Esophageal fistula.