食管癌、贲门癌术后复发再手术治疗

Reoperation for recurrent carcinoma of the esophagus and cardia

目的 探讨食管癌、贲门癌术后复发再手术治疗的适应证及手术方式。方法 总结 1986年至 2 0 0 1年间 2 6例食管癌、贲门癌术后复发患者再次手术经验。男 18例 ,女 8例 ,年龄 4 3～ 6 9岁。食管癌术后 14例 ,贲门癌术后 12例。病理证实吻合口复发 15例 ,食管切缘残留癌继发 3例 ,癌残留食管床再发 2例 ,局部淋巴结转移 6例。结果 手术切除 2 0例 ,探查 6例。术后出现并发症 6例 ,手术死亡 1例。术后生存 5年以上 2例 ,3年以上 3例 ,2年以上 8例 ,1年以上 5例。结论 对食管癌、贲门癌术后复发患者 ,若病变未侵及动脉、气管 ,无远处转移 ,心肺功能可以耐受手术者 。

Objective: To study the indications and modes in reoperation for recurrent carcinoma of the esophagus and cardia Methods: Between 1986 and 2001, 26 patients with recurrent esophageal and cardic cancer after the first operation underwent reoperation Among them, 14 had esophageal cancer and 12 cardic cance Eighteen patients were male and 8 female, with age ranging from 43 to 69 years old, Pathologically Previous anastomatic replase was seen in 15 patients, recurrent lesion of residual esophagus in 3, and recurrent cancerous residue at the esophageal bed in 2,and 6 patients showed lymph node metastasis Results: The resectability rate was 76 9% (20/26) and the hospital mortality was 3 8%(1/26) Postoperative complications occurred in 6 patients with a morbidity of 19% (5/26) The follow-up showed that 2 patients survived for 5 years, 3 for 3 years and 8 for 2 years Conclusion: Under careful preoperative assessment and patients' selection, some patients with recurrent carcinoma of the esophagus and cardia should receive the activer treatment of reopration