同时发生的食管胃重复癌的外科治疗

目的探讨同时发生的食管、胃重复癌的外科治疗方法及效果.方法1985年1月至2005年1月收治同时发生的食管、胃重复癌12例,均为男性,平均年龄56.8岁.全组均行手术治疗,成功完成同期食管次全切除并全胃切除,结肠代食管并空肠“P”袢代胃重建消化道10例,食管内翻拔脱并全胃切除,结肠代食管并空肠“P”袢代胃重建消化道1例,手术探查1例.结果全组无围术期死亡.术后颈部吻合口瘘2例,不全肠梗阻1例,均经保守治疗后痊愈;术后腹部切口裂开1例,二期缝合治愈.9例获得随访,1、3、5年生存率分别100%、44.4%、22.2%.结论同期食管次全切除并全胃切除,结肠代食管并空肠“P”袢代胃重建消化道是根治同时发生的食管、胃重复癌安全有效的外科治疗方法.

Surgical treatment of synchronous esophageal cancer associated with gastric cancer

Objective To investigate the operative technique and operative effects of synchronous esophageal cancer associated with gastric cancer. Methods 2 cases (all males, average age 56.8 years) suffered from synchronous esophageal cancer associated with gastric tumor underwent surgical treatment from January 1985 to January 2005. The diagnosis, radical operative methods and the results were studied. Results 10 patients underwent subtotal esophagectomy reconstructed with colon and total gastrectomy reconstructed with P-shaped jejunum. One patient underwent transhiatal esophagectomy reconstructed with colon and total gastrectomy reconstructed with P-shaped jejunum. Only in one patient reconstruction with colon failed because of dysplasia of arc of Riolan. There was no perioperative mortality. Two patients had post-operative anastomotic leakage, one patient post-operatively had incomplete intestinal obstruction and one patient had post-operative abdominal incisive dehiscence. All these post-operative complications were cured. Nine patients were followed up and the 1-, 3-, 5-year survival rate was 100%, 44.4% and 22.2%, respectively. Conclusion Synchronous subtotal esophagectomy with reconstruction with colon and total gastrectomy with reconstruction with P-shaped jejunum was safe and effective radical operation for synchronous esophageal cancer associated with gastric tumor.