食管癌、贲门癌术后复发再手术治疗

目的：探讨食管癌、贲门癌术后复发再手术治疗的适应证及手术方式。方法：总结1986年至2001年间26例食管癌、贲门癌术后复发患者再次手术经验。男18例，女8例，年龄43—69岁。食管癌术后14例，贲门癌术后12例。病理证实吻合口复发15例，食管切缘残留癌继发3例，癌残留食管床再发2例，局部淋巴结转移6例。结果：手术切除20例，探查6例。术后出现并发症6例，手术死亡1例。术后生存5年以上2例，3年以上3例，2年以上8例，1年以上5例。结论：对食管癌、贲门癌术后复发患者，若病变未侵及动脉、气管，无远处转移，心肺功能可以耐受手术者，应积极再次手术。

Reoperation for recurrent carcinoma of the esophagus and cardia

Objective: To study the indications and modes in reoperation for recurrent carcinoma of the esophagus and cardia Methods: Between 1986 and 2001, 26 patients with recurrent esophageal and cardic cancer after the first operation underwent reoperation Among them, 14 had esophageal cancer and 12 cardic cance Eighteen patients were male and 8 female, with age ranging from 43 to 69 years old, Pathologically Previous anastomatic replase was seen in 15 patients, recurrent lesion of residual esophagus in 3, and recurrent cancerous residue at the esophageal bed in 2,and 6 patients showed lymph node metastasis Results: The resectability rate was 76 9% (20/26) and the hospital mortality was 3 8%(1/26) Postoperative complications occurred in 6 patients with a morbidity of 19% (5/26) The follow-up showed that 2 patients survived for 5 years, 3 for 3 years and 8 for 2 years Conclusion: Under careful preoperative assessment and patients' selection, some patients with recurrent carcinoma of the esophagus and cardia should receive the activer treatment of reopration