胃大部分切除术后食管癌的手术治疗和远期疗效

 目的　探讨胃大部分切除术后食管癌的手术治疗方法和远期疗效。方法　 85例胃大部分切除术后的食管癌患者均采用剖左胸食管癌切除 ,保留胃短血管 ,将残胃、脾脏及胰尾移入左侧胸腔 ,行食管、残胃吻合术重建消化道。结果　手术切除率 91.8% ,术后并发症率 10 .3% ,无手术死亡 ,1,3,5 ,10年生存率分别为 85 .7% ,5 0 .7% ,30 .6 %和 18.8%。结论　手术为胃大部分切除术后食管癌患者最有效的治疗手段。采用食管残胃吻合重建消化道 ,方法简单 ,既能够达到较好的治疗效果 ,也有利于提高患者的消化功能及生存质量。

Operative Technique and Effect for Carcinoma of the Esophagus after Distal Subtotal Gastrectomy

Objective To investigate the surgical technique and long-term survival rate for carcinoma of the esophagus after distal subtotal gastrectomy. Methods 85 patients with esophageal carcinoma following distal subtotal gastrectomy were performed resection of the tumor through left thoracotomy. The procedure involved preserving the short gastric blood vessel and transporting the residual stomach, the spleen and tail of the pancreas into the left thoracic cavity, and using the residual stomach to reconstruct the alimentary tract. Results The respectability of all the patients was 91.8%. The operative complication rate was 10.3% and no operative mortality. The 1,3,5,10-year survival rate was 85.7%, 50.7%, 30.6% and 18.8% respectively. Conclusion Surgical resection is the optimal management method for the patients with esophageal carcinoma after distal subtotal gastrectomy. The reconstruction of digestive tract using the residual stomach is not only simple but also can achieve a better curative effect, promote the digestive function and improve the quality of life.