食管癌术后再发胸胃癌的外科治疗  

Surgical treatment of gastric cancer after esophagectomy

作　　者：江万里[1] 曾文慧[2] 王新[3] 宋恒雅 杨森 黄杰[1] 谢颂平[1] JIANG Wanli;ZENG Wenhui;WANG Xin(Department of Thoracic Surgery,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院胸外科,430060 [2]武汉大学人民医院光谷院区外科 [3]河南省南阳市中心医院胸外科

出　　处：《临床外科杂志》2020年第7期631-633,共3页Journal of Clinical Surgery

摘　　要：目的探讨胃代食管术后再发胸胃癌外科治疗的可行性。方法回顾性分析武汉大学人民医院胸外科2013年6月~2018年12月期间收治或手术会诊的7例食管癌根治术并胃代食管术后再发胸胃癌病人行胸胃癌切除术的临床资料。结果本组7例病人中,男性6例,女性1例;年龄53~73岁,平均年龄63.2岁。首次手术与胸胃癌诊断间隔时间2.8~15年不等。本组无围术期死亡病例;手术时间170~580分钟,出血量350~1100 ml;术后发生肺部感染2例,心律失常1例;颈部吻合口瘘1例,经切口换药两周后治愈。所有病例均获随访12个月,均获得正常进食,体重无下降。结论对于食管癌术后再发胸胃癌的病人,如果病变较为局限,外科切除是一个可供选择的治疗方案。Objective To investigate the clinical efficacy of resection for Thoracic Gastric Cancer(TGC)after esophagectomy.Methods Between June 2013 and December 2018,7 individuals with gastric cancer in the reconstructed gastric tube after esophagectomy in Renmin Hospital of Wuhan University were studied.Results A total of 7 patients with TGCs were selected for this study.There were 6 male patients,the average age at diagnosis was 63.2 years(range:53~73)and that the interval between esophagectomy and cancer onset in the reconstructed gastric tube ranged from 2.8 to 15 years.There were no operative or in-hospital mortalities.The operative time ranged from 170 min to 580 min and the blood loss ranged from 350 to 1100 ml.Postoperative pulmonary infection occurred in 2 cases and arrhythmia in 1 case.Neck anastomotic fistula occurred in 1 case,which was cured two weeks after dressing change through incision.The postoperative follow-up was made for 12 months in the whole patients and all of them were alive with eating normally.Conclusion The development of TGC should be taken into consideration during the extended follow-up of patients undergoing esophagectomy for cancer.Gastrectomy should be considered the preferred treatment modality in operable patients with locally invasive tumor.

关 键 词：胸胃癌 食管癌术后 食管切除术 

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