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目的：探讨二切口与三切口食管癌切除胃代食管术疗效及生活质量。方法；我院自1980年7月至1991年12月行食管瘤切除胃代食管术594例，其中经左颈胸二切口464例，经右颈胸腹三切口130例。结果：三切口组术后并发症、死亡率明显高于二切口组（P〈0．05），术后1、3、5年生存率偏低于二切口组，无统计学意义（P＞0．05）。但淋巴结阴性与阳性之间比较，5年生存率有极显著性差异（P＜0．01）。两组术后生活质量比较，三切口组术后进食量、进食后胸闷不适、体重下降等3项指标与二切口组有显著性差异（P＜0．05）。结论：出现以上结果的原因与三切口病历选择有关，胃代食管术对病人术后生活质量影响较大，三切口组更为明显。加强对早期食管瘤的诊断与治疗，是提高远期生存率的关键。
Objective: To investigate the curative effect and quality of life of gastrectomy for esophagectomy with two incisions and three incisions. Methods: From July 1980 to December 1991, 594 patients underwent esophageal resection of gastroesophageal disease in our hospital. Among them, 464 patients underwent left cervical and thoracic incisions and 130 patients underwent three right cervical and thoracocentric incisions. Results: The postoperative complications and mortality were significantly higher in the three incision group than in the two incision group (P<0.05). The 1-, 3-, and 5-year survival rates were lower in the three incision group than in the two incision groups, and there was no significant difference (P> 0.05). However, there was a significant difference in 5-year survival rate between lymph node negative and positive (P<0.01). Comparing the postoperative quality of life between the two groups, there was a significant difference between the three incisions group in terms of postoperative food intake, chest tightness and discomfort after eating, and weight loss (P<0.05). Conclusion: The reasons for the above results are related to the choice of three-incision medical records. Gastric esophageal surgery has a greater impact on postoperative patient quality of life, and the three-incision group is more apparent. Strengthening the diagnosis and treatment of early esophageal tumors is the key to improving long-term survival.