残胃贲门癌和食管癌的外科术式选择

目的 探讨残胃贲门癌和食管癌的外科术式选择及处理要点。方法 1991-2003年间18例残胃贲门癌和食管癌患者，其中食管中段癌3例，食管下段癌2例，贲门癌13例。行残胃代食管2例，结肠代食管3例，空肠代食管胃13例。结果 全部治疗病例中术后吻合口瘘1例，17天死亡，上切缘阳性1例。1年生存率72.2%(14/18)。3年生存率50%（9/18）。结论 结肠代食管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、空肠代部分食管及胃。

Surgical procedure of cardiac and esophageal carcinoma after gastrectomy

Objective To study the surgical procedure and feature of cardiac or esophageal carcinoma after gastrectomy. Methods From 1991 to 2003,of 18 patients after gastrectomy with cardiac or esophageal carcinoma, 3 cases with mid-esophageal carcinoma,2 cases with distal esophageal carcinoma,13 cases with cardiac carcinoma. Remnant gastric was used to rebuilt digestive tract in 2 cases;colon was used in 3 cases;jejunum was used in 13 cases. Results Of all cases,anastomotic leakage occurred in 1 case who died after operation at 17 days;upper fringe was postive in 1 case.Survival rate was 72 2%(14/18)and 50%(9/18)in 1 year and 3 years respectively.Conclusion Reconstruction of diges-tive tract after gastrectomy in the patient with esophageal and cardiac carcinoma,colon was suitable choice when anastomosis was performed in cervical;thoracic anastomosis can be used remnant stomach or jejunum.