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目的探讨残胃代食管治疗胃大部切除术后食管癌的手术方法及效果。方法回顾分析我院1996年2月至2012年7月手术治疗14例胃大部切除术后食管癌患者的临床资料。其中男13例,女1例,年龄57.2(49~65)岁;5例行弓上吻合,9例行弓下吻合。结果手术时间(2.3+0.4)h,术中失血量(270.0+60.0)ml;术后禁饮食时间(7.3+1.8)d,住院时间(13.7+3.1)d,无吻合口瘘和围术期死亡;术后并发症发生率为28.57%(4/14),以肺部炎症和心律失常为主。术后1年、3年和5年生存率分别为85.7%、50.0%和21.4%。结论残胃代食管,将残胃连同脾脏、胰尾移至胸腔,行食管残胃吻合术,适用于治疗胃大部切除术后中下段食管癌,具有一定的优越性。
Objective To investigate the surgical method and effect of residual gastric esophagus on esophageal cancer after subtotal gastrectomy. Methods The clinical data of 14 patients with esophageal cancer after radical gastrectomy were retrospectively analyzed from February 1996 to July 2012 in our hospital. Including 13 males and 1 females, aged 57.2 (49 to 65) years old; 5 cases of bow on the anastomosis, 9 cases of arch anastomosis. Results The operation time (2.3 + 0.4) h and intraoperative blood loss (270.0 + 60.0) ml; postoperative fasting time of diet (7.3 + 1.8) d and hospital stay (13.7 + 3.1) d without anastomotic fistula and perioperative period Died. The incidence of postoperative complications was 28.57% (4/14), mainly pulmonary inflammation and arrhythmia. The 1-year, 3-year and 5-year survival rates were 85.7%, 50.0% and 21.4% respectively. Conclusion The gastric remnant esophagus, the residual stomach together with spleen and pancreatic tail moved to the thoracic esophageal stump anastomosis, is suitable for the treatment of lower esophageal cancer after subtotal gastrectomy, has some advantages.