摘要
目的为了简化操作和减少围术期并发症，该研究利用残胃重建消化道，探讨食管中段、远端胃同时性重复癌的外科治疗方法及效果。方法回顾性分析2003年1月--2011年5月手术治疗的6例食管中下段、远端胃同时性重复癌的临床资料。结果全组均同期行远端胃及食管次全切除术，其中保留胃短血管、残胃翻转倒置逆行与食管及空肠吻合重建消化道（以下简称残胃倒置重建消化道术）3例，保留胃网膜右血管弓、残胃顺行与食管及空肠吻合重建消化道（以下简称顺行残胃重建消化道术）3例。全组无围术期死亡。术后肋软骨炎1例，扩创治愈，腹腔感染1例，经保守治疗后痊愈。6例均获得随访，2例生存超过4年，1、3年生存率分别100％、50％。结论同期远端胃及食管次全切除、保留胃短血管残胃翻转倒置或保留胃网膜右血管弓、顺行残胃食管吻合重建消化道是食管、胃重复癌安全有效的外科治疗方法。只要指征选择得当，手术会给患者带来生存的收益。
Objective To simplify the operative performances and reduce the post- opera- tive complications, this study is using leftover gastria to reconstruct digestive canal to investigate the surgical therapy methods and results of synchronous intermediate esophageal cancer associated with distal gastric tumor. Methods Six patients that suffered from synchronous esophageal cancer asso- ciated with distal gastric tumor underwent surgical treatment from January 2003 to May 2011 were analyzed retrospectivelyl Results All patients underwent subtotal distal gastrectomy and subtotal esophagectomy. Three patients were reconstructed with digestive canal that the gastricae breves was reserved and the leftover gastria was turned over and was anastomosed with esophageal and jejunum （ shorted as reconstructed digestive canal with the leftover gastria turned over below）. Another three patients were reconstructed with digestive canal that the gastro - epiploica dextra arcus was reserved and the leftover gastria was anastomosed with esophageal and jejunum directly （shorted as recon- structed digestive canal without the leftover gastria turned over below）. There was no periopretive- mortality. One patient had post - operative rib chondritis, that was cured with debridement. An- other patient had post - operative abdominal infection, that was cured with expectant treatment. All patients were followed up and 2 patients survived over 4 years. The first and third year survival rate was 100% and 50%. Conclusion Subtotal distal gastrectomy and subtotal esophagectomy, and then reconstructed digestive canal with or without leftover gastria turned over were safe and effective to treat synchronous esophageal cancer associated with distal gastric tumor . The surgical treatment can prolong survival time to the patients if right choice is chosen.
出处
《实用临床医药杂志》
CAS
2011年第23期54-56,共3页
Journal of Clinical Medicine in Practice
关键词
食管肿瘤
胃肿瘤
肿瘤
重复癌
esophageal neoplasms
stomach neoplasms
neoplasms
multiple primary
surgical procedures
operative
