胃大部切除术后食管癌和贲门癌的消化道重建方式探讨

Discussion on Reconstruction of the Digestive Tract for Carcinoma of the Esophagus and Cardia of Stomach after Subtotal Gastrectomy

对曾经作过胃大部切除的食管癌和贲门癌患者以何种方式重建消化道,常感复杂和困难。本文报告14例病人重建消化道的几种方式,并结合国内一些作者的术式,进行了讨论。作者认为对贲门癌患者宜采用残胃切除及食管空肠吻合术;下段食管癌可采用食管残胃吻合术或食管-空肠-残胃吻合术;中上段食管癌则采用食管-空肠或食管-结肠-残胃吻合术。

It was difficult to choose the best method to reconstruct the digestive tract for a patient, who had underwent subtotal gastrectomy, with carcinoma of esophagus or cardia of stomach.Fourteen cases were reported in this paper.It was suggested that the remaining stomach from subtotal gastrectomy should be removed and then an esophagojejunostomy was performed for cardiac carcinoma; esophagogastric anastomosis or esophagojejunogastrostomy for the carcinomas of the lower third of esophagus, and esophagocologastrostomy or esophagojejunogastrostomy for the carcinomas of upper or middle third of esophagus.