贲门癌合并门静脉高压症治疗探讨

The therapy of cardia cancer complicated with portal hypertension

目的分析贲门癌合并门静脉高压症患者手术后的疗效,并探讨本术式行断流的彻底性。方法48例贲门癌合并门静脉高压症患者施行食管、上半胃(或)全胃切除、脾切除,特别强调行贲门癌根术基础上结扎、切断异常侧支循环。结果随访6个月至20年,2例生存超过15年以上,6例超过10年,10例超过5年,15例超过2年,6例因肿瘤复发而死亡,术后未发现再出血,3例有轻、中度食管静脉曲张。结论贲门癌根治术式对门静脉高压症患者是一种比较彻底的断流术,在加强支持治疗的基础上,选择贲门癌根治术能达到一举两得的功效。

Objectives To summarize the postoperative efficacy of cardia cancer complicated with portal hypertension, and explore the long-term results of the operation. Method Forty-eight patients with cardia cancer complicated with portal hypertension underwent the esophagectomy ,proximal subtotal gastrectomy or total gastrectomy and lienectomy. Ligating and abscising the abnormal collateral circulation after curative resection of gastric cardia cancer were emphasized in operation. Results After following up for 6 months to 20 years,2 of the 48 patients live for more than 15 years,6 live for more than 10 years, 10 live for more than 5 years, 15 live for more than 2 years and 6 patients died of recurrence. No haemorrhage occurred after operation. Three of them had mild or moderate esophageal varices. Conclusions Curative resection of gastric cardia cancer is a relatively through devascularization operation. Choosing curative resection of gastric cardia cancer can get the effect of killing two birds with one stone on the basis of fortified nutritional support.