机械吻合术在贲门癌外科治疗中两个问题的探讨  

Investigation of two problems in mechanical anastomosis of cardial carcinoma surgical treatment

作　　者：李国珍[1] 冯锡建 

机构地区：[1]河南省辉县市人民医院胸外科,453600

出　　处：《肿瘤防治研究》2003年第1期49-50,共2页Cancer Research on Prevention and Treatment

摘　　要：目的　评价贲门癌近端胃切除、食管残胃机械吻合术的治疗效果。方法　对 2 16例贲门癌近端胃切除的下切缘癌残留及术后的生活质量进行回顾性调查分析。结果　 2 16例贲门癌近端 1/ 3胃切除 6 9例 ,1/ 2胃切除 10 6例 ,2 / 3胃切除 4 1例。下切缘癌残留依次为 0、2 .8% (3/ 10 6 )、9.8% (4/ 4 1)。全部病例术后均有不同程度的返流性食管炎 ,严重者呕吐、进食困难。结论　贲门癌一旦侵及胃小弯上部 ,近端 1/ 2胃切除 ,仍不能确保下切缘无癌残留 ,应手法行食管胃端端高套吻合术 ,或全胃切除后行食管空肠Roux en Y吻合术。Objective To evaluate the therapeuti cefficacy abort cardial carcinoma proximal gastric resection?esophagus gastric remnant mechanical anastomosis.Methods Proceed retrospective study to 216 cases infra incisal border carcinoma remain of cardial carcinoma proximal gastric resection and quality of life after esophagus gastric remnant mechanical anastomosis.Results Of the 216 cases,69 cases cardial carcinoma 1/3 proximal gastric resection,106 cases 1/2 gastric resection,41 case 2/3 gastric resection.Infra incisal border carcinoma remain by turns is 0?2.8%(3/106)?9.8%(4/41) . Each case has various degree reflu esophagitis.Conclusion Once cardial carcinoma has invaded superior part of lesser curvature of stomach,1/2 proximal gastric resection can not avoided infra incisal border carcinoma remain absolutely, esophagus gastric remnant end to end tall cuff anastomosis should be performmed manually,or performming esophago jejunum Roux en Y anastomosis after total gastrectomy.

关 键 词：机械吻合术 贲门癌 外科治疗 

分 类 号：R735.205[医药卫生—肿瘤]