残胃癌贲门胃底切除余胃食管再吻合的实验研究和临床应用

Experimental and clinical study on gastroesophagostomy after cardiectomy of gastric stump

１９８０年以来作者对残胃贲门癌的治疗问题进行了实验和临床研究。作者选用杂种犬６０只，先以Ｂ－Ⅰ式及Ｂ－Ⅱ式行胃大部切除。２０周后残胃行贲门胃底切除，余胃食管吻合。病理见余胃血液循环良好，食管余胃吻合口愈合良好。在实验研究基础上，对收治的残胃贲门癌２５例，１７例行残胃贲门胃底切除，余胃食管吻合，术后恢复良好。实验和临床均证实残胃贲门胃底切除余胃食管再吻合的方法是安全可行的，既符合器官保存的手术原则，也符合肿瘤切除原则。

hybrid dogs,divided into 2 groups, were subjected to subtotal gastrectomy in B Ⅰ and B Ⅱ pattern respectively.20 weeks later,resection of cardia and fundus ventriculi and the gastric remnant esophagus anastomosis was performed.There were more omentum blood vessel embedments about the gastrojejunostomic and gastroduodenostomic stoma and collateral circulation was plentiful.In 1980,there were 25 patients with cardiac cancer of the gastric stump with an average period of 13 years and 3 months following subtotal gastrectomy and a mean age of 59.1 years.19 patients were subjected to exploratory thoractomy,17 resection of cardia and fundus of gastric stump and gastroesophagostomy (9 to tunnel gastroesophagostomy and 8 end to side esophagogastrostomy).The largest tumor was 5cm×4cm.Except for a death due to intestinal obstruction following operation,the others attained a good recovery.Resection of cardia and fundus of gastric stump and gastroesophagostomy can be carried out for patients with cardiac cancer for gastric stump,which is in line with the principle of conservation surgery.