“双血管”供血在结肠间置治疗食管癌中的应用

Clinical Application of Dual Vessel in Transverse Colon Interposition for Esophageal Caner

目的探讨结肠中动脉及左结肠动脉"双血管"供血在结肠代食管术中的临床效果。方法回顾性分析12例接受结肠代食管术的食管癌病例,其中11例为残胃食管癌,1例为食管-胃双源癌,取结肠肝曲、横结肠及结肠脾曲为移植肠段,顺蠕动吻合,以结肠中动脉及左结肠动脉"双血管"作供血管。结果全组死亡1例,术后并发症包括肺部感染2例,吻合口瘘2例,腹内疝1例。术后1年和3年生存率为63.6%和36.4%。结论采取顺蠕动方向吻合术,结肠中动脉及部分左结肠动脉"双血管"作移植结肠段供血管效果满意。

Objective To evaluate the clinical efficacy of transplanted colon supplied by both middle colic artery and branch of left colic artery in esophageal replacement with colon（ ERC）. Methods 12 patients who had undergone colon interposition for esophageal replacement were studied retrospectively. 11 cases were esophageal cancer after gastrectomy,and 1 was esophageal-gastric double primary cancer. All patients received ERC along the peristaltic direction by the hepatic flexure,transverse colon,splenic flexure. Results There was 1 operative death in the whole group. The postoperative complications consisted of anastomic leakage（ 2 cases）,lung inflammation（ 2 cases） and internal abdominal hernia（ 1 case）. 1-and 3-year survival rates were 63. 6% and 36. 4%,respectively. Conclusion The key of this technique are choosing of isoperistaltic transposition and middle colic artery and branch of left colic artery for blood supply,and the result is satisfactory.