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目的 探讨胃部分切除术后食管癌的手术方式及经验。方法 8例胃大部切除术后食管癌行手术切除,选用3种不同的术式进行消化道重建。行右胸、上腹正中及左颈三切口结肠代食管4例。左后外侧切口残胃脾胰尾移入胸腔,主动脉弓下食管残胃底端侧吻合2例。左后外侧切口食管下段残胃切除,食管空肠Roux—Y吻合2例。结果 全组无手术死亡。颈部食管回肠吻合口瘘2例。结论 对于胃部分切除术后食管癌应根据食管肿瘤的部位和残胃的大小选择不同术式。发生于中段及上段的食管癌常用结肠代禽管。发生于下段者,常用残胃或空肠移入胸腔重建消化道。
Objective To explore the surgical approach and experience of esophageal cancer after partial gastrectomy. Methods Eight cases of esophageal cancer were resected after subtotal gastrectomy. Three different methods were used to reconstruct the digestive tract. There were 4 cases of colon esophageal incision in the right chest, middole of the upper abdomen and left neck. The left posterolateral incision remnant stomach spleen and pancreas tail into the chest cavity, the aortic arch bottom esophageal residual gastric end-to-side anastomosis in 2 cases. Left posterolateral incision of the lower esophagus resection of the stomach, Roux-Y esophagojejunal anastomosis in 2 cases. Results No operative death occurred in the whole group. Esophagogastric anastomosis fistula in 2 cases. Conclusion For esophageal cancer after partial gastrectomy, different surgical procedures should be selected according to the location of the esophageal tumor and the size of the residual stomach. The esophageal cancer that occurs in the middle segment and the upper segment is usually a colonic poultry bird. Occurred in the lower segment, commonly used residual stomach or jejunum into the chest to rebuild the digestive tract.