食管癌贲门癌合并肝硬化7例同期手术治疗探讨

Carcinoma of Esophagus Cardia Cancer Associated with Cirrhosis 7 Cases Surgical Treatment Experience During the Same Period

目的探讨食管癌贲门癌合并肝硬化患者同期实施食管胃吻合术和脾切除术的可行性。方法回顾2006年1月—2011年6月7例同期实施食管胃吻合术和脾切除术的临床资料。结果该组7例患者均经手术治愈,无一例死亡。术后1例发生颈部吻合口瘘,经治疗痊愈。术后随访1~5年,患者能从事轻体力劳动,无上消化道出血患者,无全血细胞减少病例。现在5例存活（生存5年1例﹑3年2例﹑1年2例﹑2例术后2年死于肝硬化相关肝昏迷）。结论食管癌贲门癌合并肝硬化同期行脾切除手术,一次手术治愈两种疾病,防治肝硬化所致的消化道出血和脾功能亢进所致全血细胞较少,提高了生活质量,值得临床推广。

Objective To investigate the carcinoma of esophagus cardia cancer associated with the same period of patients with liver cirrhosis implementation of esophagogastrostomy and splenectomy feasibility. Methods Retrospective 7 cases clinical material implemented esophagogastrostomy and splenectomy successively from January 2006 to June 2011. Results The 7 patients by surgery were cured, and no 1 case death. 1 case which ocurred cervical anastomotic fistula were recoveried after the treatment . All the cases were followed up from 1 to 5 years. Patients that were performed esophagogastric anastomosis andsplenectomy successively could engage in slight manual labor,and weren’t found upper gastrointestinal hemorrhage and pancytopenia.2 cases died of hepatic coma in 2years, Now 5 patients which no upper gastrointestinal hemorrhage and pancytopenia live . such as survival five years in 1, 3 years in 2 cases, 1 year in 2 cases. Conclusion The patients that were performed esophagogastric anastomosis and splenectomy successively are improved postoperative life quality and reduced the operation cost. The operation method deserved clinical application.