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食管纵膈胃颈部吻合术治疗食管癌疗效分析

路培发 孔令贵 杜宝青 方志勇 王斌 Pei-fa Ling-gui Bao-qing Zhi-yong 中国实用医刊 2010年第21期

摘要:目的 总结食管癌行食管次全切除胃代食管颈部吻合术的临床经验.方法 回顾性分析132例胸段食管癌手术患者,所有患者均采用食管次全切除胃代食管经食管床颈部吻合术式.结果 全组无围术期死亡患者,无切缘癌阳性.吻合口瘘4例(3.0%),吻合口狭窄5例(3.8%),喉返神经损伤3例(2.3%).103例获随访,所有患者术后生活质量满意,无明显胃食管返流的症状;3、5年生存率分别是78.5%、34.6%.结论 食管次全切除食管纵膈胃颈部吻合术能显著降低食管癌患者围术期病死率和并发症发生率,是治疗食管癌的一种安全有效的手术方式. Abstract: Objective To conclude the clinical experience of subtotal esophagectomy and cervical gastroesophagostomy for the treatment of esophageal carcinoma. Methods One hundred and thirty-two patients with esophageal carcinoma of thoracic part who underwent surgical treatment were analyzed retrospectively.All patients were given subtotal esophageal resection and cervical gastroesophagostomy. Results There were no perioperative mortality,no edge-residual cancer,no postoperative gastroesophageal reflux in all patients.Complications included:cervical anastomotic leakage of 4 cases(3.0%);anastomotic stenosis of 5 (3.8%); larygeal nerve injury of 3 (2.3%).One hurdred and three patients who were followed up showed normal and satisfied life quality.The 3-year,5-year survival rate were 78 5%,34.6%, respectively. Conclusions Cervical gastroesophagostomy after subtotal esophagectomy can decrease peioperative mortality and incidence of complications and can be used as a safe and effective surgical procedure for the treatment of esophageal carcinoma.

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