Moreno González E, González-Pinto I, García García I, Gómez Sanz R, Loinaz Segurola C, Bercedo Martínez J, Figueroa Andollo J, Palma Carazo F, Marcello Fernández M
General and Digestive Surgery Service C, Hospital 12 de Octubre, Madrid, Spain.
Surg Today. 1992;22(6):517-22. doi: 10.1007/BF00308897.
The authors report their experience with transhiatal esophageal resection accumulated during the period between January 1978 and March 1990. Indications for the procedure included cancer of the gastric cardia (26.3%), cancer of the hypopharynx (3.8%), cancer of the esophagus (59.2%), and benign esophageal disease (9.8%). Esophageal substitution was performed using a tubulized stomach (63.6%), ileo-ceco-coloplasty (28.5%), left colon (7.6%), and jejunum (0.3%). The majority of patients with neoplastic disease were found to be in an advanced stage (67.3% of esophageal cancer patients and 69.7% of cancer of the cardia patients with stage III disease). The mean intra-operative volume of blood transfused varied between 533 and 1,220 ml. Sixteen patients required hospitalization in the intensive care unit. The mean length of post-operative hospitalization varied between 16.8 and 20.6 days. Operative complications included hemorrhage (0.3%) and tracheal injury (0.6%). Operative (30 day) mortality was 5.8%. Causes of death included respiratory insufficiency (35.2%), pulmonary sepsis (23.5%), abdominal sepsis (17.8%), and others (undefined, 23.5%). The 5 year survival was 48.5% for cancer of the gastric cardia, 57.1% for cancer of the hypopharynx and 11.8% for esophageal cancer.
作者报告了他们在1978年1月至1990年3月期间积累的经裂孔食管切除术经验。该手术的适应症包括贲门癌（26.3%）、下咽癌（3.8%）、食管癌（59.2%）和良性食管疾病（9.8%）。食管替代采用管状胃（63.6%）、回盲结肠成形术（28.5%）、左结肠（7.6%）和空肠（0.3%）。发现大多数肿瘤性疾病患者处于晚期（食管癌患者中67.3%以及III期贲门癌患者中69.7%）。术中平均输血量在533至1220毫升之间。16名患者需要入住重症监护病房。术后平均住院时间在16.8至20.6天之间。手术并发症包括出血（0.3%）和气管损伤（0.6%）。手术（30天）死亡率为5.8%。死亡原因包括呼吸功能不全（35.2%）、肺部感染（23.5%）、腹部感染（17.8%）和其他（未明确，23.5%）。贲门癌的5年生存率为48.5%，下咽癌为57.1%，食管癌为11.8%。
