食管癌与贲门癌合并局限性支气管扩张12例同期手术治疗体会

Synchronal Surgery of Esophageal Cancer or Carcinoma of Gastric Cardia with Complicating Limited Bronchiectasis

目的:探讨食管癌、贲门癌合并局限性支气管扩张患者同期实施食管胃吻合术和肺叶或肺段切除术的可行性。方法:回顾2006年5月～2010年5月12例同期实施食管胃吻合术和肺叶或肺段切除术的资料。结果:本组12例患者手术后均治愈,无一例死亡。早期并发症肺部感染1例,室性二联律1例,治疗后痊愈。术后随访1～5年,患者能从事轻体力劳动,无慢性咳嗽、咯脓痰或咯血等症状,呼吸道感染次数减少。2例术后2～3年因复发死亡,1例术后4年因"脑出血"死亡。9例无支气管扩张症状生存。结论:食管癌、贲门癌合并支气管扩张患者同期手术,一次治愈两种疾病,提高了患者术后生活质量,降低了手术费用,值得临床推广应用。

Objective： The present work aims to explore the feasibility of esophagogastric anastomosis, lobectomy, or pulmonarysegment resection in patients who suffer trom esophageal cancer or carcinoma of gastric cardia with complicating limited bronchiectasis. Methods： Data of 12 cases with cardia cancer or esophageal cancer with complicating limited bronchiectasis who underwent esophagogastric anastomosis and lobectomy or resection of pulmonary segment from May 2006 to May 2010 were reviewed. Results： All 12 patients were cured after surgery and are currently performing normal activities. Early pulmonary infection occurred in one of the patients after surgery, but the patient subsequently recovered. Ventricular bigeminy was found in one case, and the patient recovered after treatment. Follows-up ranging from 1 to 5 years were conducted in all 12 cases. After the surgery, the patients were able to engage in minimal manual labor, without respiratory symptoms such as chronic cough, expectoration, and hemoptysis. Respiratory infections were also reduced. Two of the patients died of recurrent cancer 2 or 3 years post surgery, and another patient died of cerebral hemorrhage at 4 years after surgery. The symptom of bronchiectasis did not recur in 9 of the cases who survived. Conclusion： Synchronal surgery with esophagogastric anastomosis, lobectomy, or pulmonary segment resection can cure two diseases simultaneously, improving patients＇ quality of life and reducing the costs of surgery. This type of treatment is worthy of clinical application and generalization.