结肠代食管术的探讨——附51例临床分析

Study of Esophageal Replacement with Colon——A Report of 51Cases

目的:探讨结肠代食管术的临床效果。方法:51例中,食管良性狭窄6例,食管癌45例,均施行结肠代食管颈部吻合术。取横结肠段48例,其中顺蠕动吻合27例,逆蠕动吻合21例;取右半结肠段3例,顺蠕动吻合。以结肠中动脉作供血血管24例,以左结肠动脉作供血血管27例。结果:全组无手术死亡。术后并发症包括颈部吻合口瘘2例,颈部伤口感染3例,喉返神经损伤1例,结肠吻合口狭窄1例,肺部感染3例。结论:结肠有丰富的血供及足够的长度,可移植至颈部与食管吻合,且效果满意。熟练的操作技术可减少并发症。

Objective:This study was designed to evaluate t he clinical experience of esophageal replacement with colon(ERC).Methods :Among 51patients,6with benign stricture and 45with esophageal carcinoma,all of them were performed cervical esophagocologa strostomy.Among 51patients,48patients received ERC by the transverse colon,including isoperistaltic anastomo sis(27/48)and antiperistaltic anastomosis(21/48);three patients received ERC along the peristaltic direction by the rig ht-side colon.In these patients,24cases were supplied blood by the arte ria colica media and 27cases by the arteria colica sin istra.Results:There was no operative death in the whole group.The postoperative complications consisted of leakage of cervical anastomosis(2cases),cervical wound inflammation(3cases),laryngeal recurrent nerve injury(1cases),lung inflammation(3cases).Conclusion:The authors conclude that colon was r ich in blood and enough in length so that it c an be grafted into neck and anastomosed with the esophagus and the result i s satisfactory.Improved surgical te chnique can reduce the incidence of c omplications of ERC.