中文摘要：

目的 探讨胸腹腔镜联合中上段食道癌根治手术中管状胃经胸骨后与食管床不同上提路径对患者术后肺功能的影响。方法 分析2014年12月至2016年2月在我院胸外科行胸腹腔镜中上段食管癌切除、食管胃颈部吻合术45例患者的围手术期临床资料,其中采用胸骨后路径者22例,食管床路径者23例,分析两组病例术后外周血气分析指标及肺功能指标。结果 经胸骨后路径组术后3天的外周血气值以及术后7天的肺功能指标优于食管床组（P〈0.05）。经胸骨后与食管床路径术后吻合口瘘（27.3%vs.17.4%）、肺部感染（13.6%vs.21.4%）发生率的差异无统计学意义（P〉0.05）。结论 经胸骨后与食管床行食管胃颈部吻合均是可行的消化道重建方式,应综合病人的因素进行个体化选择。

英文摘要：

Objective To explore the effect on pulmonary function after different approaches for gastric Tube Reconstruction in Esophagectomy Combined with Thoracoscopy and Laparoscopy for Esophageal carcinoma of upper and middle Segment. Methods A total of 45 patients underwent esophagectomy combined with thoracoscopy and laparoscopy for esophageal carcinoma of upper and mid- dle segment from December 2014 to February 2010 were selected. There were 22 patients in prevertebral group and 23 in retrosternal group. Index of blood gas analysis and lung function after operation with two groups were analyzed. Results Index of blood gas analysis on the 3th day and lung function on the 7th day after operation was better in retrosternal group than that in prevertebral group（ P 〈 0. 05 ）. There were no significant differences between the retrosternal group （ n = 22） and the pre - vertebral group （ n = 23 ） with regard to anastomotic leak （27.3% vs. 17.4% ） and pneumonia （ 13.6% vs. 21.4% ）. Conclusion Retrosternal and prevertebral routes for gastric tube reconstruction are both acceptable methods in esophagectomy. Individualized gastric tube reconstruction should be con- sidered.