Bagajevas Aleksandras
Klaipeda Hospital, Liepojos 15, 5808 Klaipeda, Lithuania.
Medicina (Kaunas). 2004;40 Suppl 1:170-3.
The aim was to evaluate interim results of surgery and plastics for esophageal diseases. From March 2002 to August 2003, 31 patients underwent esophageal resections in the Department of Thoracic Surgery of Klaipeda Hospital. The following operations were performed: 10 patients (32.3%) had transthoracic resections, 10 patients (32.3%) - transhiatal resections, 2 patients (6.5%) - Lewis type, 5 patients (16.1%) - Garlock type and 4 patients (12.9%) - first step of Thoreck type operations. Twenty-five patients (80.6%) underwent surgery due to cancer, 3 patients (9.7%) due to esophagus perforation, 1 patient (3.2%) due to peptic stricture, 1 patient (3.2%) due to post-burn stricture, and 1 patient (3.2%) due to gastric necrosis. In 7 cases (22.6%) combined esophageal resections were performed: 2 patients (6.5%) with lung segmentectomies, 2 patients (6.5%) with liver metastasis resections, 1 patient (3.25%) with right lower lobectomy, and 2 patients (6.5%) with proximal gastric metastasis resection. In 58% of patients we observed postoperative complications; lethal outcome was present in 5 patients (16.1%).
Subtotal esophageal resection with gastric pipe reconstruction and two-level lymphadenectomies are sufficient radical treatment in cancer patients. Postoperative mortality (16.1%) after 31 resections depends on stage of disease, performance status, comorbidity, surgeon experience and type of operation.
目的是评估食管疾病手术及整形手术的中期结果。2002年3月至2003年8月，克莱佩达医院胸外科对31例患者进行了食管切除术。实施了以下手术：10例患者（32.3%）行开胸切除术，10例患者（32.3%）行经裂孔切除术，2例患者（6.5%）行刘易斯式手术，5例患者（16.1%）行加洛克式手术，4例患者（12.9%）行托雷克式手术的第一步。25例患者（80.6%）因癌症接受手术，3例患者（9.7%）因食管穿孔接受手术，1例患者（3.2%）因消化性狭窄接受手术，1例患者（3.2%）因烧伤后狭窄接受手术，1例患者（3.2%）因胃坏死接受手术。7例患者（22.6%）进行了联合食管切除术：2例患者（6.5%）行肺段切除术，2例患者（6.5%）行肝转移灶切除术，1例患者（3.25%）行右下叶切除术，2例患者（6.5%）行近端胃转移灶切除术。58%的患者出现术后并发症；5例患者（16.1%）死亡。
食管癌患者行食管次全切除、胃管重建及二级淋巴结清扫是足够的根治性治疗。31例切除术后的死亡率（16.1%）取决于疾病分期、身体状况、合并症、外科医生经验及手术类型。
