胃切除后食管癌手术方法选择

 目的　探讨胃大部切除或全胃切除后再患食管癌手术治疗术式。方法　回顾分析 1990年 1月至 2 0 0 1年 12月收治胃切除术后再患食管癌 2 9例资料。食管癌切除后的消化道重建方式 :残胃代食管术 2 0例、空肠代食管术 3例、结肠代食管术 6例。结果　 2 9例除 1例颈部食管结肠吻合口瘘、1例胸部食管残胃吻合口瘘、1例吻合口狭窄、3例肺部感染、其余均Ⅰ期愈合。结论　胃大部切除术后食管中下段癌采用残胃代食管术 ,食管中上段癌行结肠代食管术更为合理

The Choice of Operation Methods in Patients with Esophageal Carcinoma after Gastrectomy

Objective To study the operation methods of patients with esophageal carcinoma after gastrectomy or resection of majority stomach.Methods Retrospective analysis 29 patients with esophageal carcinoma after gastrectomy from January,1990 to December,2001.The rebuilding operation methods of digest duct were done after esophageal carcinoma resection.We made use of gastric remnant instead of esophagus in 20 patients,jejunum instead of esophageal in 3 patients and colon instead of esophageal in 6 patients.Results All cases were primary healing except for esophageal colon stoma fistula in cervical in one case, esophageal gastric remnant stoma fistula in thoracic in one case,stoma constriction in one case and pneumonia in 3 cases. Conclusion In patients with esophageal carcinoma after gastrectomy ,making use of gastric remnant instead of esophageal are reasonable to patients who had middle or lower esophageal carcinoma and colon instead of esophageal were suitable to patients with upper or middle esophageal carcinoma.