论文部分内容阅读
目的：探讨胃大部切除术后食管癌和贲门癌的手术方式、处理要点和预后。方法：１９８９ 年１ 月～１９９７ 年１２ 月２４ 例胃大部切除术后食管癌和贲门癌患者实行手术治疗，其中食管癌１５ 例，贲门癌９例。残胃代食管３ 例，空肠代食管胃７ 例，回结肠代食管胃５ 例，结肠代食管胃经胸骨后颈部吻合９ 例。结果：胸腔内吻合１５ 例，１ 例发生吻合漏（６ ．７ ％ ） ，第１９ 天死亡，颈部吻合９ 例，２ 例发生吻合口漏（２２ ．２ ％ ） ，无死亡。１ 年生存率为８６ ．７ ％ ，３ 年生存率为５３ ．３ ％ 。结论：结肠经胸骨后代食管胃是颈部吻合较理想的选择，胸腔内吻合可视具体情况选择残胃、空肠、回结肠代食管胃。
Objective: To explore the surgical methods, treatment points, and prognosis of esophageal and cardiac cancer after major gastrectomy. Methods: From January 1989 to December 1997, 24 patients with esophageal and cardiac cancers underwent surgical treatment, including 15 cases of esophageal cancer and 9 cases of cardiac cancer. There were 3 cases of residual gastro-esophagus, 7 cases of jejunal esophageal stomach, 5 cases of ileocolic esophageal stomach, and 9 cases of colon esophagogastric anastomosis of the sternum. RESULTS: Intrathoracic anastomosis was performed in 15 cases, anastomotic leakage occurred in 1 case (6.7%), died on the 19th day, and neck anastomosis was found in 9 cases. Anastomotic leakage occurred in 2 cases (22.2%). No death occurred. The 1-year survival rate was 86. 7 %, 3-year survival rate was 53. 3%. Conclusion: Esophagogastric colostomy is an ideal choice for cervical anastomosis in patients with colonic sternal debridement. Intrathoracic anastomosis can be selected according to the specific situation of residual stomach, jejunum, ileocolic esophagus stomach.