中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
2期
31-33
,共3页
路培法%孙俊峰%王强%程学飞%郑晓勇%孙作永
路培法%孫俊峰%王彊%程學飛%鄭曉勇%孫作永
로배법%손준봉%왕강%정학비%정효용%손작영
食管肿瘤%食管次全切除%回结肠代食管%结肠血管
食管腫瘤%食管次全切除%迴結腸代食管%結腸血管
식관종류%식관차전절제%회결장대식관%결장혈관
Esophageal neoplasm%Subtotal esophagectomy%Ileocolon interposition for esophageal replacement%Colic vessels
目的 探讨食管次全切除回结肠代食管颈部吻合术治疗早中期食管癌的临床经验及远期疗效.方法 回顾性分析1991年至2009年间151例早中期食管癌患者的临床资料,所有患者均行食管次全切除回结肠代食管经胸骨后路颈部吻合术.术后TNM分期,1期39例,Ⅱa期86例,Ⅱb期26例.其中上胸段13例,中胸段95例,下胸段43例.结果 术后颈部吻合口瘘9例(6.0％),喉返神经损伤7例(4.6％),颈部吻合口狭窄11例(7.3％),肺部感染5例(3.3％),死亡3例(2.0％).总并发症发生率为23.2％.135例获随访1～15年,术后3、5、10年生存率分别为79.5％、46.3％、26.7％.患者术后均恢复日常饮食习惯,生活质量满意,能从事一般工作及体力劳动.结论 食管次全切除回结肠代食管经胸骨后路颈部吻合术治疗早、中期食管癌可明显提高患者的远期生存率和术后生活质量,提高外科技术,可显著降低结肠代食管术的并发症发生率.
目的 探討食管次全切除迴結腸代食管頸部吻閤術治療早中期食管癌的臨床經驗及遠期療效.方法 迴顧性分析1991年至2009年間151例早中期食管癌患者的臨床資料,所有患者均行食管次全切除迴結腸代食管經胸骨後路頸部吻閤術.術後TNM分期,1期39例,Ⅱa期86例,Ⅱb期26例.其中上胸段13例,中胸段95例,下胸段43例.結果 術後頸部吻閤口瘺9例(6.0％),喉返神經損傷7例(4.6％),頸部吻閤口狹窄11例(7.3％),肺部感染5例(3.3％),死亡3例(2.0％).總併髮癥髮生率為23.2％.135例穫隨訪1～15年,術後3、5、10年生存率分彆為79.5％、46.3％、26.7％.患者術後均恢複日常飲食習慣,生活質量滿意,能從事一般工作及體力勞動.結論 食管次全切除迴結腸代食管經胸骨後路頸部吻閤術治療早、中期食管癌可明顯提高患者的遠期生存率和術後生活質量,提高外科技術,可顯著降低結腸代食管術的併髮癥髮生率.
목적 탐토식관차전절제회결장대식관경부문합술치료조중기식관암적림상경험급원기료효.방법 회고성분석1991년지2009년간151례조중기식관암환자적림상자료,소유환자균행식관차전절제회결장대식관경흉골후로경부문합술.술후TNM분기,1기39례,Ⅱa기86례,Ⅱb기26례.기중상흉단13례,중흉단95례,하흉단43례.결과 술후경부문합구루9례(6.0％),후반신경손상7례(4.6％),경부문합구협착11례(7.3％),폐부감염5례(3.3％),사망3례(2.0％).총병발증발생솔위23.2％.135례획수방1～15년,술후3、5、10년생존솔분별위79.5％、46.3％、26.7％.환자술후균회복일상음식습관,생활질량만의,능종사일반공작급체력노동.결론 식관차전절제회결장대식관경흉골후로경부문합술치료조、중기식관암가명현제고환자적원기생존솔화술후생활질량,제고외과기술,가현저강저결장대식관술적병발증발생솔.
Objective To investigate the clinical experience and long-term functional results of subtotal esophagectomy and ileocolon interposition for esophageal replacement in patients with esophageal cancer of stageⅠ-Ⅱ.Methods The clinical datas of 151 cases of esophageal cancer underwent subtotal esophagectomy and esophageal reconstruction with ileocolon graft from 1991-2009.The postoperative pathological stage was:39 cases in stage Ⅰ,86 cases in stage Ⅱa and 26 cases in stage Ⅱb.Results The incidence of postoperative complication was 23.2％,including cervical anastomotic leakage in 9 cases(6.0％),laryngeal nerve injury in 7 cases(4.6％),cervical anastomotic stenosis in 11 cases(7.3％),respiratory infection in 5 cases(3.3％)and death in 3 cases(2.0％).Among the 135 cases who were followed up for 1-15 years,the overa11 3-year,5-year and 10-year survival rates were 79.5％,46.3％ and 26.7％,respectively.All survival patients had restored norual life with satisfying quality.normal and satisfying life quality can be achieved in patients with esophageal cancer of stage Ⅰ-Ⅱ by ileocolon interposition for esophageal replacement after subtotal esophagectomy.The incidence of postoperative complications can be reduced obviously by improvement of surgical technique and skill.
