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作者等对下咽颈段食管癌切除后行游离空肠移植重建术44例,其中男33例,女11例,年龄44～87岁,平均62岁。病变部位,PS25例,PC16例,PW2例,Ce 1例;下咽癌初次病例Ⅰ期1例,Ⅱ期5例,Ⅲ期6例,Ⅳ期29例,颈段食管癌Ⅱ期1例;术前放疗者2例。重建方法。“U”形皮肤切口,全周性切除喉咽颈段食管并行颈廓清。原发灶切除安全边缘上方约2cm、下方约1.5cm。颈廓清时确保适宜的吻合动静脉,继从Treitz韧带30cm处切取带肠系膜血管蒂的空肠30cm,血管吻合后,将空肠以顺蠕动与咽作端端或端侧吻合、与食管作端端吻合。结果:观察时间最长者8年6个月,最短2个月,平均27.6个月。26例生存,17例死亡,不明1例。死亡病例中手术死亡1例,死于癌症11例,其它原因5例。空肠成活41例
The author et al. performed 44 cases of free jejunal reconstructive surgery after removal of esophageal carcinoma of the lower limbs, including 33 males and 11 females, aged 44-87 years with an average age of 62 years. The lesions included 25 cases of PS, 16 cases of PC, 2 cases of PW2, and 1 case of Ce. The primary cases of hypopharyngeal carcinoma were stage I in stage I, stage II in 5 cases, stage III in 6 cases, stage IV in 29 cases, and cervical esophageal carcinoma in stage II in one case. Preoperative radiotherapy in 2 cases. Reconstruction method. “U”-shaped skin incision, full-thickness resection of the esophagus of the neck of the larynx and neck with neck dissection. The primary lesion was removed approximately 2 cm above the safe edge and approximately 1.5 cm below. When the neck clearance was clear, an appropriate arteriovenous vein was ensured, and the jejunum with mesenteric vascular pedicle was cut 30 cm from the Treitz ligament 30 cm. After the vascular anastomosis was performed, the jejunum and the pharyngeal were anastomosed end-to-end or end-to-end anastomosis, and the end of the jejunum was anastomosed with the esophagus. . Results: The longest observation period was 8 years 6 months, the shortest 2 months, an average of 27.6 months. 26 cases survived, 17 died, and 1 was unknown. Among the deaths, 1 died of surgery, 11 died of cancer, and 5 were other causes. 41 cases of jejunal survival