胃大部切除术后贲门癌和食管癌的根治性手术对病人临床疗效的研究  

Clinical efficacy of radical surgery for cardiac cancer and esophageal cancer after partial gastrectomy

作　　者：徐澄澄[1] 李忠诚[1] Xu Chengcheng;Li Zhongcheng(Department of Thoracic Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院胸外科,江苏苏州215006

出　　处：《腹部外科》2018年第6期404-406,共3页Journal of Abdominal Surgery

基　　金：国家自然科学基金(81702254)

摘　　要：目的探讨残胃状态下治疗贲门癌和食管癌的外科方法的选择及对病人预后的影响。方法回顾性研究2005年1月至2014年12月苏州大学附属第一医院收治的27例胃大部切除术后残胃贲门癌及食管癌的临床资料,分析不同手术方法对病人疗效及预后的影响。结果本组27例病人行根治性手术切除。手术采用颈部高位吻合5例,胸腔内吻合22例,无1例术中死亡。术后3例出现肺部感染,2例出现颈部吻合口瘘,2例出现喉返神经损伤、声音嘶哑,1例术后胃排空障碍。1例死于术后肺部感染并发急性呼吸窘迫综合征,26例顺利出院。失随访1例,随访25例病人2年中长期存活16例,5例死于原发肿瘤,4例死于其他原因。手术治疗明显改善了病人的生存质量,5年生存率达36.0%。结论残胃状态下贲门癌和食管癌病人根据个体差异可以选择不同的的外科方法,术后并发症与普通贲门食管癌无明显的差别,临床疗效满意。Objective To investigate the choice of surgical methods for the treatment of cardiac cancer and esophageal cancer in the residual stomach and its impact on the prognosis of patients.Methods The clinical data of 27 patients with residual gastric cardia cancer and esophageal cancer after partial gastrectomy were retrospectively analyzed from January 2005 to December 2014.The effects of different surgical methods on the efficacy and prognosis of patients were also analyzed.Results Twentyseven patients underwent radical resection,including high neck anastomosis in 5 cases and intrathoracic anastomosis in 22 cases,and no case died during operation.Nine patients developed postoperative complications,including 3 cases of pulmonary infection,2 cases of neck anastomotic leakage,2 cases of recurrent laryngeal nerve injury hoarse and 1 case of postoperative gastric emptying disorder,and 1 case died of postoperative pulmonary infection complicated with AIDS.Twenty-six cases were successfully discharged,1 case lost follow-up,and 25 cases were followed up for 2 years,including a long-term survival of 16 cases.Five cases died from primary tumor,and 4 cases died from other reasons.Surgical treatment significantly improved the quality of life of patients,with a 5-year survival rate of 36.0%.Conclusions Patients with cardiac cancer and esophageal cancer under residual gastric disease can choose different surgical methods according to individual differences,and the postoperative complications were not significantly different from those in common cardiac esophageal cancer.The clinical efficacy is satisfactory.

关 键 词：残胃贲门癌 食管癌 根治性手术 

分 类 号：R656[医药卫生—外科学]