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目的 探讨结肠间置术治疗胃切除术后食管癌的疗效。方法 对26例胃切除术后食管癌患者的手术方式、并发症、治疗结果及术后胃肠功能进行分析。结果 1例移植段结肠颈段坏死,4例颈部吻合口瘘,1例术后8 d死于急性心肌梗死。结肠顺蠕动间置18例,1年生存率77.8％,2年生存率44.5％;结肠逆蠕动间置8例,1年生存率62.5％,2年生存率37.5％。胃肠功能等级评定显示,结肠顺蠕动间置术后胃肠功能优于结肠逆蠕动间置。结论 胃切除术后腹膜腔的严重粘连和胃空肠吻合口的压迫可导致横结肠短缩和结肠左动脉分支变细。手术中应力争行结肠顺蠕动间置。
Objective To investigate the effect of colon interposition on esophageal carcinoma after gastrectomy. Methods 26 cases of esophageal cancer after gastrectomy surgery, complications, treatment and postoperative gastrointestinal function were analyzed. Results One case had necrosis of the cervical segment of the colon, four cases of anastomotic leakage of the neck, and one died of acute myocardial infarction 8 days after the operation. Colonic peristalsis was performed in 18 cases. The 1-year survival rate was 77.8% and the 2-year survival rate was 44.5%. The colon reverse peristalsis was used in 8 cases. The 1-year survival rate was 62.5% and the 2-year survival rate was 37.5%. Gastrointestinal function rating showed that colon peristalsis after surgery gastrointestinal function is better than colon peristalsis interposition. Conclusions Severe peritoneal adhesions in the peritoneal cavity and compression of the gastrojejunostomy can lead to transverse colon shortening and narrowing of the left colon artery. Strenuous surgery interspersed with peristalsis.