摘要
目的 总结 5 4 8例结肠代食管术经验体会 ,分析降低并发症率和病死率的要点。方法 统计 5 4 8例的病种、手术种类、移植肠段和供血管的种类、结肠段上提径路、移植肠段的蠕动方向以及手术技术等。结果 术后 (住院期间 ) 86例 (15 .6 9% )发生并发症 130例次 ,死亡 10例 (1 82 % )。食管癌组1、3、5年生存率分别为 85 6 %、6 0 8%、32 4 %。食管改道术组 1、3、5年分别为 5 4 6 %、4 0 8%、18 4 %。食管良性疾病获随访者 86 % ,远期随访 2～ 2 5年 ,均恢复正常生活、工作。结论 采取顺蠕动方向吻合术、首选结肠左动脉升支作为供血管、经胸骨后径路、颈部食管 -结肠一层吻合术以及妥善防止并发症(喉返神经损伤、胸结肠综合征和食管盲囊综合征 )是并发症率降至 15 6 9%、病死率降至 1 82 %的关键。
Objective: To review the experience of the esophageal replacement with colon. Methods: The data from 548 patients were summarized and analyzed, including the diseases type, operations type, selection of the colon segment, colon blood supply and pathway for pulling-up of transplanted colon. Results: Postoperative complications occurred in 86 cases (15。69%), with 10 deaths (mortality rate 1。82%). The 1,3,5 years survival rate were 85。6%, 60。8% and 32。4%, respectively. All the patients in the group of benign esophageal diseases survived well with normal lives and activities, after 2～25 years of follow-up. Conclusion: There are several keys to ameliorate the results and reduce the complications rate to 15。69% and mortality rate to 1。82%. The keys are choosing of isoperistaltic transposition, ascending branch of left colica artery, retrosternal tunnel, a single-row suturing by cervical esphagocolostomy and prevention of complications (injury of recurrent laryngeal nerve, thoracic colon syndrome and esophageal pouch syndrome).
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2003年第6期338-340,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
