结肠代食管术12例临床分析

The Clinical Analyses of Esophageal Replacement with Colon of 12 Cases

目的探讨结肠代食管术在消化道重建中的应用价值。方法 12例中,8例为食管癌术后吻合口复发,3例为食管癌既往有胃大部切除病史,1例为食管癌术后吻合口狭窄放置支架后吻合口气管瘘。9例采用横结肠加部分降结肠代食管,左结肠动脉为供血血管,顺蠕动吻合;3例采用横结肠加部分升结肠代食管,中结肠动脉为供血血管,逆蠕动吻合。结果全组并发症有吻合口瘘4例,胸部切口感染1例。结论结肠是理想的复杂食管癌切除后消化道重建器官的选择,该手术方法较简单,且无明显并发症。

Objective To explore the application of esophageal replacement with colon in the digestive tract reconstruction surgery.Methods Among the 12 patients,there were 8 patients with postoperative anastomotic recurrence of esophageal cancer,3 patients with esophageal cancer after subtotal gastrectomy,1 patient with anastomotic-esophageal fistula who received esophageal stent placement for anastomotic stricture.Utilizing part of the transverse colon and descending colon as the substitution for esophagus and using the left colonic artery as the supporting vessel in an isoperistaltic anastomosis was adopted in the 9 patients.Utilizing part of the transverse colon and ascending colon as the substitution for esophagus and using the middle colonic artery as the supporting vessel in reversed peristaltic position was adopted in the 3 patients.Results The postoperative complications consisted of leakage of anastomotic stoma（4 cases）,wound infection of chest（1 case）.Conclusion Colon is the ideal choice for digestive tract reconstruction in complex esophageal cancer surgery.The surgical method is simple,and there are no major complications.