替代食管的结肠段上提径路探讨

The clinical study on the route of colon segment for replacement of esophagus

目的 探讨结肠代食管 (ERC)术移植结肠段上提径路的适应证、手术技术及与生存质量的关系。方法 统计 5 38例ERC手术资料 ,分析长期生存率和生活质量的效果。结果 手术并发症发生率 2 3 42 % ,病死率 1 6 7%。恶性食管疾病ERC术后 1、3、5年生存率分别为 85 6 %、6 0 8%、32 4%。移植结肠段未置于食管床内者占 5年生存者的 80 %。结论 胸骨后径路病例的生存期长 。

Objective To study the indications, surgical techniques of replacement with colon(ERC) and the effect of living quality. Methods 538 cases with ERC were included in this study. The relations between the three routes and the long term survival rate, the living quality were analyzed. Results The postoperative morbidity was 23 42%, and overall mortality rate was 1 67%. In patients with malignant diseases of the esophagus treated by ERC,1,3,5 years survival rates were 85.6%,60.8% and 32.4%, respectively. Among the patients who survived for more than 5 years, 80% adopted the non posterior mediastinal route. Conclusion Attention must be paid to the choice of the route through which the colon segment was pulled up to the neck. The retrosternal route could be achieved with long term survival and good living quality.