胃大部切除术后食管癌的外科治疗(30例残胃食管吻合术)  

Surgical Treatment Esophageal Carcinoma in Patients Who had had Partial Gastrectomy—A Report of 30 Cases

作　　者：郭启祥[1] 许建华[1] 林建清[1] 郑今奋[1] 

机构地区：[1]福建医科大学附属第二医院肿瘤科

出　　处：《中国肿瘤临床》1998年第8期573-575,共3页Chinese Journal of Clinical Oncology

基　　金：福建省教委科研基金

摘　　要：自１９８９年６月至１９９６年６月对３０例胃大部切除术后食管癌采用经左胸切除，后充分游离残胃脾胰体尾并将其移入左胸内行残胃食管弓下、弓上或颈部吻合，取得良好效果。术后并发症５例（１６．６％）。其中吻合口瘘１例，非手术治愈，脓胸２例，心律失常频发室早、房早各１例，无手术死亡。作者认为本手术方法操作方便，手术时间短，除颈部吻合外通常一个切口一个吻合口即能完成手术，通过对残胃充分游离一般能上提２０～２５ｃｍ，使吻合无张力，同时食管切除长度达无瘤残留，同时还保留了残胃，有利于消化功能，是一种有实用意义的手术方式。The authors report on 30 cases of post subtotal gastrectomy esophageal carcinoma treated with complete removal of tumor after mobilization of the residual stomach, spleen, and pancreas which were transposed into the left thorax, and ultimately gastroesophagostomy was performed either supra or infra aortically or in the neck. Complications occurred postoperatively in five cases (16 .6%) including 1 anastomotic fistula which recovered under conservative manipulation 2, pyothorax 1 frequent ventricular premature beat and 1 atrial premature beat . No operative mortality was observed. The authors conclude that this operative per formance was easy to carry out and not time consuming and that one skin incision was ample enough for the procedure except when cervical anastomosis was needed. As a rule the gastric remnant could be elongated to as long as 20 25cm which provided anastomosis to be performed without tension with tumor thoroughly resected. Because the remnant stomach is preserved the digestive function remains just as good.

关 键 词：食管肿瘤 外科手术 胃切除术后 手术方式 

分 类 号：R735.105[医药卫生—肿瘤]