胃大部切除术后食管癌的外科治疗  被引量:6

Surgical treatment of esophageal carcinoma in patients with partial gastrectomy in the past

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作  者:徐善明[1] 陈安清[2] 钮海弟[1] 

机构地区:[1]复旦大学附属金山医院胸外科,上海200540 [2]复旦大学附属中山医院心外科

出  处:《上海医学》2005年第7期586-588,共3页Shanghai Medical Journal

摘  要:目的探讨胃大部切除术后食管癌患者的外科治疗方法和疗效。方法回顾性分析1995年1月至2004年10月,金山医院和解放军149医院共对12例胃大部切除术后食管癌患者行外科手术治疗,手术方式为充分游离残胃,连同脾脏、胰尾一并移入左胸腔,行食管-残胃吻合术。主动脉弓上吻合4例,主动脉弓下吻合6例,胸膜顶吻合2例;手工吻合10例,器械吻合2例。结果所有患者手术均顺利,术后无严重并发症发生,住院期间无一例死亡。术后随访10例,失访2例,随访率为10/12例。1年生存率为8/10例,3年生存率为5/8例,5年生存率为2/6例。结论对胃大部切除术后食管癌患者采用残胃连同脾脏、胰尾移入胸腔,行食管-残胃吻合术,具有手术操作简单、创伤小、手术时间短、并发症少的优点,并保留了胃的消化功能和消化道的正常解剖结构。Objective To appraise the surgical treatment method and curative effects of post-subtotal gastrectomy esophageal carcinoma. Methods Surgical operative method of post-subtotal gastrectomy esophageal carcinoma in 12 patients from January 1995 to October 2004 was retrospectively analyzed in Jinshan Hospital and PLA 149 Hospital. The residual stomach, spleen and tail of pancreas were transposed into the left thoracic cavity and ultimately gastroesophagostomy was performed including, anastoimosis above the aortic arch in 4 cases, below the aortic arch in 6 and at the level of cupula of pleura in 2; with hand sewing was used in 10 and suture machine in 2. Results The operation was carried out smoothly in all cases. No serious complications or inhospital mortality. A follow-up study rated 83% 10/12 patients showed one year survival as 8/10, three years 5/8, five years 2/6. Conclusion The residual stomach, spleen and tail of pancreas are transposed into the left thoracic cavity and gastroesophagostomy was successfully performed in esophageal carcinoma patients with pasthistory ofsubtotal gastrectomy. This procedure is simple, mild trauma, low complications with reservation of gastric digestive function and normal anatomical relationship of digestive organs. (Shanghai Med J, 2005,28 : 586-588).

关 键 词:胃大部切除术后 食管癌 外科治疗 外科治疗方法 主动脉弓上吻合 外科手术治疗 严重并发症 3年生存率 胃吻合术 2004年 

分 类 号:R735.1[医药卫生—肿瘤]

 

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