胃大部切除术后食管癌患者消化道重建

Digestive tract reconstruction for esophageal cancer patients after subtotal gastrectomy

目的探讨胃大部切除术后食管癌患者上消化道重建的策略。方法胃大部切除术后食管癌患者31例，其中结肠代食管重建消化道16例，空肠代食管8例，残胃代食管7例。结果全组无手术死亡患者，术后发生并发症8例（25．8％），治疗后全组患者均痊愈出院，患者1、3、5年生存率分别为96．8％、45．2％和32．3％。结论胃大部切除术后再发食管癌患者可通过手术根治，结肠、空肠或残胃均可用于消化道重建，掌握不同术式特点及适应证，有利于提高手术成功率，改善患者预后。

Objective To study the strategies of digestive tract reeonstruetion for esophageal eaneer patients after subtotal gastreetomy. Methods A total of 31 esophageal cancer patients after subto- tal gastreetomy were included in this research,including 16 patients with colonic interposition,8 patients with jejunal interposition, and 7 patients with residual stomach interposition. Results There were no oper- ative deaths but eight patients had postoperative complications（25.8% ）. All patients were cured and sue- eessfully discharged. The overall survival rates at 1,3, and 5 years were 96.8% ,45.2% and 32.3%. Conclusion Patients with esophageal cancer after subtotal gastreetomy could be treated through radical operation. The digestive tract can be reconstructed by using colon ,jejunum or residual stomach. Studying different methods and their indications can be helpful in improving success rate and prognosis.