頁籤選單縮合
題名 | 食道胃境界癌手術經絡--下胸骨分割, 上腹部正中切開法 |
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作 者 | 楊明泉; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 16:4 1983.12[民72.12] |
頁次 | 頁311-316 |
分類號 | 416.241 |
關鍵詞 | 食道胃境界癌手術; 下胸骨分割; 上腹部正中切開法; |
語文 | 中文(Chinese) |
中文摘要 | 對於食進胃境界癌的手術,下胸骨分割,上腹部正中切開法,提供寬廣的手術野以進行食道旁的淋巴廓清;一般於第四肋間,避開兩側的胸內動靜脈,作胸骨的T字型分割,並延長切開線通過橫隔膜,而以本進入肋膜腔,作心臟後縱膈部位的淋巳廓清及食道下部的切除。 因為這種手術都以平躺的姿勢進行,除了可以減少病人開胸需要變換體位的麻煩外,又能得到良好的現野;同時術後有關肺部方面的併發症,可減至最低的程度;可說是一種既簡便且失血量較少的手術方法。 本院外科自民國六十九年十一月至今,利用此法對五例境界癌,作食道部份切除,並分別實施胃全切除二例,亞全切除三例,手術後均迅速復原,茲提出來報告討論。 |
英文摘要 | The mid-epigastric, xiphoid-excising, sternum-splitting incision provides effective approach to the lesions in the region of the esophagocariac junction. The incision is started in the midline from the umbilicus to about the fourth intercostal space. The xiphoid process is excised, and the sternum is split to about the level of the 4th ICS and is transected. Then the peritoneal incision is extended to the diaphragm which is incised at least to the reflection of the pericardium. The patient is placed in the supine position, not only need not change position, but also can provide effective exposure for dissection, resection and anastomosis with less operative complication. In general, it is the simplest and bloodless method. From November 1980, we have ever experienced 4 adenocarcinoma and 1 epidermoid carcinoma cases by this method at Kaohsiung Medical College Hospital. We have performed partial esophagectomy with total gastrectomy in two and proximal gastrectomy in three, followed by esophagojejunal or esophagogastric reconstruction. The post-operative courses were rather smooth and rapid recovery. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。