残胃搭桥术重建消化道连续性治疗食管下段、胃同时性重复癌临床报告

A report of the reconstruction of alimentary tract by residual gastric bypass surgery in 14 patients with reduplicated cancers of the lower esophageal and stomach

目的探索残胃搭桥术重建消化道连续性治疗食管下段、胃同时性重复癌手术效果。方法采用残胃搭桥术重建消化道连续性治疗的临床14例食管下段、胃同时性重复癌进行回顾性分析,并与先期开展的17例传统的结肠代食道手术方式进行对照分析。结果两组病例在手术时间、住院天数、术后吻合口瘘及肺部感染方面存在差异(P<0.01,P<0.05);术后死亡率较对照组比较有显著意义(P<0.05),1年生存率及3年生存率方面较对照组无显著差异(P>0.05)。结论残胃搭桥术重建消化管连续性治疗食管下段、胃同时性重复癌较先期开展的空肠代食道手术有较大的改进,手术时间、住院天数、术后并发症显著改善,可极大地减少术后死亡率,术后1年、3年生存率无明显差异。

Objective ： To explore the effect of the reconstruction of alimentary tract by residual gastric bypass surgery to treat a series of patients with reduplicated cancers of the lower cscphageal and stomach. Methods： The cases of 14 patients with reduplicated cancers of the lower esophageal and stomach treated by residual gastric bypass surgery to reconstruct ali- mentary tract were reviewed retrospectively, and were comparatively analyzed regarding 17 cases of patients treated by tradi- tional colonic interposition for esophageal substitution. Results： Ti^ere were some significant differences between two groups of cases in operation time, hospitalization days, postoperative mortality, postoperative anastomotic fistula and lung infection （P〈 0.01 ,P〈 0.05） ; There was no significant difference in survival rate between 1 year and 3 year（P〉 0.05）. Con- clusion： Compared to traditional operation, reconstruction of alimentary tract by residual gastric bypass surgery to treat pa- tients with reduplicated cancers of the lower esophageal and stomach achieves greater improvement in operation time, hospi- talization days and the postoperative complications, which can greatly reduce the postoperative mortality rate.