关键词: 手辅助腹腔镜, 肥胖结直肠癌, 疗效 ,  ,

Abstract: [Abstract]  Objective  To investigate the feasibility and efficacy of transorally inserted anvil （OrVil）in the surgical treatment of cervical and upper thoracic esophageal cancer  Methods  Reviewed 29 cases of cervical and upper thoracic esophageal cancers with OrVil esophagealgastric nearpharyngeal anastomosis.12 cervical esophageal cancers，17 upper thoracic esophageal cancers.Preoperative gastroscopy suggested that the upper margin of the tumor was 20（1723）cm from the median of the incisors.1 case was performed with detachment of esophagus without thoracotomy and 28 cases were threated by Mckeown.All patients underwent single or bilateral selective cervical lymphadenectomy.Results  Postoperative pathology was squamous cell carcinoma，R0 resection rate was 100%.2（6.9%）cases of postoperative anastomotic fistula，2 （6.9%）cases of pulmonary infectiont，5（17.2%）cases of hoarseness，8（27.6%）cases of drinking water cough.The median time for oral feeding was 10 （7～22）days.No perioperative death.During the 3～36 months followup，3 cases were recovered from hoarseness，drinking water cough was improved，anastomotic stenosis occurred in 1 case （3.4%），tumor recurrence rate was 17.2% （5/29），mortality was 6.9% （2/29）.Conclusion  Gastroesophageal anastomosis close to the pharynx by using the technique of OrVil in cervical and upper thoracic esophageal cancer can improve laryngeal preservation and R0 resection rate，it is safe and feasible，recent result was satisfactory.

Key words:  ,  , handassisted laparoscopy, obesity colorectal cancer, curative effect