贲门癌术后吻合口复法癌再手术治疗

目的:探讨贲门癌术后吻合口复法癌再手术的可能和适应症。方法:回顾1992年至2004年我科尝试性行该手术16例,再次手术采用左胸切口和胸腹联合切口,手术切除9例(56.3%);术中经胃造瘘术4例;行空肠造瘘术3例。结果:术后并发肺部感染3例;胸腔积液1例。手术切除者中2年和3年生存率分别为44.4%(4/9)和11.1%(1/9)。7例无法手术切除者均在3~11个月内死亡。结论:贲门癌术后吻合口复法癌再手术难度较大,经严格掌握手术适应症,尤其对距第一次手术时间1年内病灶较小,仍可再次积极手术,以首次经腹手术者为佳。

Surgical Treatment of Anastomotic Recurrence following Resection of Cardiac Carcinoma

Objective:To explore the possibility and indication of surgical treatment of anastomotic recurrence following resection of cardiac carcinoma.Method:Reoperation was performed in 16 patients with anastomotic recurrence from 1992 to 2004.Secondary resection was in 9(56.3%) and jejunostomy in 3.Result:In 9 patients,pneumonia occurred in 3 and hydrothorax in 1 after secondary resection.2-and 3-year survival rates were 44.4%(4/9) and 11.1%(1/9).7 patients who didn't receive secondary resection were died between 3 and 8 month.Conclusion:Secondary resection is difficult but still effective for some patients with anastomotic recurrence especially in one year following resection of cardiac carcinoma.