食管癌伴肝硬化的手术治疗  

Surgical treatment of esophageal cancer with liver cirrhosis

作　　者：楼良潮[1] 陆文博[1] 

机构地区：[1]解放军第113医院胸外科,浙江宁波315040

出　　处：《中国实用医刊》2015年第12期75-76,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨食管癌伴肝硬化的手术治疗指征、方法和围术期治疗。方法回顾分析解放军第113医院胸外科食管癌伴肝硬化手术治疗12例患者的临床资料。肝功能child分级：A级11例，B级1例。左进胸食管癌手术11例，其中弓下吻合9例，弓上吻合3例，同期行脾脏切除8例，胸腔镜辅助食管癌根治术1例。结果12例食管癌伴肝硬化手术患者痊愈出院，术后胸腔引流液明显增多。结论食管癌合并肝硬化患者，肝功能childA级首先考虑手术治疗，B级要慎重。合并脾功能亢进者同期行脾脏切除，处理好围术期能减少手术并发症。Objective To study the surgical indication, methods and perioperative treatment of esophageal cancer with liver cirrhosis. Methods The clinical data of 12 cases of esophageal cancer with liver cirrhosis were analyzed retrospectively. Eleven patients were classified as grade A and one patient as grade B by child gradation. There were 11 cases with esophageal cancer underwent a left transthoracic, below aortic arch in 9 cases, above aortic arch in 3 cases among those patients, 8 cases underwent splenectomy during the operation, 1 case underwent thoracoscopic surgery. Results All the patients in 12 cases of esophageal cancer with liver corrhosis were cured. The fluid of chest drainage were markedly increased after operation. Conclusions The surgical treatment for esophageal carcinoma with liver cirrhosis is the first choice for grade child A, but for child B the treatment should be seriously considered. Patients with hypersplenism should undergo splenectomy at operation, and perioperative management should be addressed to reduce operative complications.

关 键 词：食管癌 肝硬化 手术治疗 

分 类 号：R575.2[医药卫生—消化系统]