食管空肠Roux-en-Y吻合在11例不可切除性晚期贲门癌的临床应用

Clinical application of Roux-en-Y esophagojejunostomy in 11 patients with unresectable advanced cardiac carcinoma

目的探究食管空肠Roux-en-Y吻合术在不能切除性晚期贲门癌治疗中的应用,并就其适应证、方法、效果进行讨论。方法 11例晚期不能切除的、合并有进食困难及消化道出血的贲门癌患者接受了食管空肠Roux-en-Y吻合术。手术方法充分游离食管下段、胃脾韧带,于贲门或癌上缘2.0 cm处横断食管,闭合远切端,旷置全胃;近端食管与空肠行Roux-en-Y吻合术。结果 11例患者恢复顺利,术后1个月可摆脱肠外营养而完全依靠经口进食。患者生活质量改善。结论食管空肠Roux-en-y吻合术对于治疗不能切除性晚期贲门癌是可行、安全的,可改善患者生存质量,但应严格掌握适应证。

Objective To study the clinical application of Roux-en-Y esophagojejunostomy in 11 patients with unresectable advanced cardiac carcinoma,and investigate its indications,surgical procedures and outcomes.Methods Eleven patients with unresectable advanced cardiac carcinoma received Roux-en-Y esophagojejunostomy because of gastric bleeding and difficulty in oral feeding.As for surgical procedures,the lower part of the esophagus was mobilized and gastrosplenic ligament disconnected,then the esophagus was disconnected 2.0 cm proximal to the cardia or carcinoma.The distant resection edge of the esophagus was closed and the stomach left alone.Roux-en-Y esophagojejunostomy was performed.Results AH 11 patients recovered successfully,and lived on oral feeding without parenteral nutrition one month after operation.The quality of life of the patients was improved and short -term survival was better.Conclusions Roux-en-Y esophagojejunostomy was feasible,safe and effective in the treatment of patients with unresectable advanced cardiac carcinoma. It can improve the quality of life of such patients concomitant with gastric bleeding and difficulty in oral feeding,but the indications should be selected strictly.