食管癌合并胃癌或胃代食管手术  

Esophageal cancer combined with gastric cancer residual esophageal surgery

作　　者：隋刚[1] 邹志强[1] 袁耒[1] 胡风标[1] 许世宁[1] 莫修鑫 Sui Gang Zou Zhiqiang Yuan Lei Hu Fengbiao Xu Shining Mo Xiuxin(Department of Thoracic Surgery, General Hospital of Ji ＇ nan Military Command , Ji＇ nan 250031, China)

机构地区：[1]济南军区总医院胸外科,250031

出　　处：《中华胸心血管外科杂志》2017年第8期499-501,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨食管癌患者同时合并胃癌行根治切除手术时能否利用残胃代食管。方法2011年3月至2016年5月，我科完成采用胃代食管的方法治疗食管癌合并胃癌患者18例。年龄52-67岁，食管病变16例位于中下段，2例位于胸上段。胃部病变4例位于近端胃，14例位于远端胃。共4种手术方法可供选择，采用近端或远端残胃替代食管，利用胃左血管或胃网膜右血管供血，胃长度不足时采用胃组织分离倒置胃管的方法。结果18例患者选择上述方法在食管癌和胃癌同期手术切除后可以完成残胃代食管的手术。结论食管癌合并胃癌的患者同期手术切除时，残胃替代食管仍是不错的选择。患者的选择和手术的设计同样重要。Objective To explore the feasibility of gastroesophagostomy when patients with esophagus carcinoma combined with stomach carcinoma. Methods In March 2011 to May 2016, our department completed with the method of generation of esophagus stomach in the treatment of esophageal cancer merger 18 cases of gastric cancer patients. Age 52 - 67, 16 cases of esophageal lesions located in the middle section, 2 cases located in the chest. 4 cases were gastric lesions located in the proximal stomach, 14 cases were located in the distal stomach Four kinds of surgical methods can be chosen from. Proximal or distal stomach could be used to replace esophagus and the blood supply came from left gastric artery or right gastroepiploic artery. Stomach tissue separation and reverse gastric tube were used if the length of stomach was insufficient. Results When resection of esophageal and gastric carcinoma were accomplished simultaneously, residue stomach can be used as a replacement of esophagus if patients were rigidly selected. Conclusion Residue stomach was a good substitute after radical resection of esophagus and gastric dual-source carcinoma. Patients chosen and surgery design were both important.

关 键 词：食管癌 胃癌 残胃 胃大部切除术 胃代食管术 

分 类 号：R735.1[医药卫生—肿瘤] R735.2[医药卫生—临床医学]