摘要
目的探讨食管癌、贲门癌切除、食管(管状胃)胃侧侧吻合术的治疗效果及应用前景。方法共有32例患者行此手术。贲门癌6例、食管癌26例;其中胸下段9例,胸中段12例,胸上段5例。术中按肿瘤手术切除原则常规游离食管及近端胃,切除肿瘤。行主动脉弓下吻合9例,经食管床主动脉弓上吻合10例,左胸左颈两切口4例,右胸顶吻合3例,右胸颈腹三切口6例。22例患者应用管状胃代食管,10例患者应用全胃代食管。行食管胃端端吻合+侧侧吻合术15例;食管胃端侧吻合+侧侧吻合术10例;胸下段食管癌患者行食管管状胃全侧侧吻合术7例。结果本组病例术后分期分别为Ⅱa期9例,Ⅱb期11例,Ⅲ期12例。全部病例手术顺利,术后未出现吻合口瘘,术后2周复查上消化道钡透及胃镜检查均见吻合口通畅、无狭窄,术后随诊0.5～2年不等,均未见吻合口狭窄。结论食管癌、贲门癌切除食管(管状胃)胃侧侧吻合术可降低吻合口并发症尤其是狭窄的发生,值得临床推广。
Objective To investigate the clinical application and efficacy of esophagectomy and side-to-side esophagogastric anastomosis in the treatment of esophageal cancer.Methods Thirty-two patients underwent esophagectomy and side-to-side esophagogastric anastomosis,including cardia cancer in 6 cases,esophageal cancer in 26;lower thoracic esophageal cancer in 9,middle thoracic esophageal cancer in 12,upper thoracic esophageal cancer in 5.The surgical procedures included total esophagectomy,gastric tube construction and side-to-side esophagogastric anastomosis.The anastomosis was performed inferior to aortic arch in 9 cases,superior to the aortic arch through the esophageal bed in 10 cases,left chest left neck in 4,top right chest in 3,neck and right chest and abdomen in 6;stomach tube in 22,total stomach in 10.end-to-end and side-to-side and esophagogastric anastomosis in 15,end-to-side and side-to-side esophagogastric anastomosis in 10,whole side-to-side esophagogastric anastomosis in 7.Results The postoperative staging was as follows： 9 stage Ⅱa cases,11 stage Ⅱb cases and 12 stage Ⅲ cases.All patients had successful operation,postoperative anastomotic fistula did not appear,the barium examination of upper gastrointestinal tract showed that the anastomotic stoma was patent without stricture in two weeks after the operation.All of the cases were followed up for 0.5 to 2 years,no anastomotic stricture was seen.Conclusion The resection of esophageal and cardia cancer with side-to-side esophagogastric anastomosis can reduce incidence of the anastomotic complications such as anastomotic stricture.This technique is worthy of wide clinical application.
出处
《中国肿瘤临床与康复》
2011年第2期175-178,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
食管肿瘤
贲门肿瘤
侧侧吻合
Esophageal neoplasms
Cardia neoplasms
Side-to-side esophagogastric anastomosis
