全食管切除左梨状窝胃(结肠)吻合术治疗颈段食管癌16例分析

Surgical treatment of cervical esophageal carcinoma with left piriform recess-gastric (or colon) anastomosis after total esophagectomy (a report of 16 cases)

目的 探讨部分下咽、全食管切除 ,左梨状窝 胃 (结肠 )吻合治疗颈段食管癌的手术方法及疗效。方法 自 1987年 11月～ 2 0 0 1年 5月采用非开胸行部分下咽、全食管切除 ,治疗颈段食管癌 16例 ,其中左梨状窝 胃吻合 12例 ,梨状窝 结肠吻合 4例。 12例作左侧颈淋巴结清扫 ,4例作双侧颈部淋巴结清扫。结果 术后轻度返流 1例 ,胃壁坏死 1例 ,吻合口瘘 1例。无喉返神经损伤 ,无手术住院死亡。 3年生存率为 4 2 .9% (6 / 14 )。结论 部分下咽、全食管切除 ,左梨状窝 胃 (结肠 )吻合是治疗颈段食管癌的一种安全、有效的方法。

Objective To evaluate the effect of left piriform recess-gastric (or colon) anastomosis after partial hypopharyngeal and total esophagectomy without thoracotomy in cervical esophageal carcinoma. Methods From Nov 1987 to May 2001, sixteen patients with cervical esophageal carcinoma were treated with left piriform recess and gastric anastomosis in 12, and colon anastomosis in 4, cleaning left cervical lympha node in 12, and bilateral in 4. Results Mild reflux, necrosis of stomach wall and leakage of stoma in 1 case each, no injury of recurrent nerve and no death occurred in the hospital. Three-year survival rate was 42.9% (6/14). Conclusion Left piriform recess and gastric (or colon) anastomosis after partial hypopharyngeal and total esophagectomy without thoractomy is an effective treatment in cervical esophageal carcinoma.