18例食管、贲门癌术后胸胃排空障碍的诊治体会

Diagnosis and treatment of gastric emptying disorder after resection of carcinoma of esophagus and gastric cardia in 18 cases

目的总结食管、贲门癌术后,胸胃排空障碍的原因及处理方法。方法回顾性分析527例食管癌、贲门癌手术患者,其中18例术后发生胸胃排空障碍,分析发生胸胃排空障碍的原因和处理方法。结果18例患者中,12例系功能性胸胃排空障碍,经保守治疗后好转;6例机械性胸胃排空障碍,其中2例经保守治疗后好转,4例经再次开胸手术治疗后好转。结论胸胃排空障碍是食管癌、贲门癌患者术后较常见的并发症,包括功能性和机械性两种,功能性胸胃排空障碍和部分机械性胸胃排空障碍用保守治疗可以好转,多数机械性胸胃排空障碍需再次行开胸手术治疗。

Objective To summary the causes and treatment of gastric emptying disorder after the resection of carcinoma of esophagus and gastric cardia. Methods Five hundred and twenty-seven cases of carcinoma of esophagus and gastric cardia were retrospectively analysed, among them 18 cases of thoraco-gastric emptying disorder occurred. The causes and treatment of gastric emptying disorder after the resection of carcinoma of esophagus and gastric cardia were analysed. Results Twelve cases of functional thoraco-gastric emptying disorder and 2 cases of mechanical thoraco-gastric emptying disorder were healed through conservativ treatment,4 cases of mechanical thoraco-gastric emptying disorder were healed through operation. Conclusion Thoraco-gastric emptying disorder is frequent complication after the resection of carcinoma of esophagus and gastric cardia. Functional thoraco-gastric emptying disorder and part of mechanical thoraco-gastric emptying disorder can be cured through conservative treatment. Most of mechanical thoraco-gastric emptying disorder need reoperation.