Paşalega M, Burdescu C, Meşină C, Mirea C, Tenea T, Vasile I
Clinica Chirurgie II, U.M.F. Craiova.
Chirurgia (Bucur). 2005 Mar-Apr;100(2):175-9.
We present the case of a 56 year old female, who in 23 years after esophagoplasty type Gavriliu II, with pre-sternal tube for esophageal chemical burn stenosis, develops a cancer in the upper third of the gastric tube, with a fast evolution to malnutrition, through lumen obturation. The evolution post-esophagoplasty was marked by malfunction of the neo-esophagus, characterized through dysphagia and distal dilatation, requiring many abdominal and pre-sternal reinterventions. The objective of the present surgical intervention was to assure a way for enteral nutrition (gastrostomy for feeding) and to extirpate the gastro-esophagoplasty tube. It is discussed the characteristic feature of the case: the difficulty of the stage-evolutive integration of this malignant disease location, the etiopathogenic factors that contributed to the malignant evolution of the antral portion of the gastro-esophagoplasty tube, the limits of the surgical treatment.
我们报告了一例56岁女性患者的病例,该患者在接受加夫里柳二世型食管成形术23年后,因食管化学性烧伤狭窄而留置胸骨前管,在胃管上三分之一处发生癌症,并通过管腔阻塞迅速发展为营养不良。食管成形术后的病程以新食管功能障碍为特征,表现为吞咽困难和远端扩张,需要多次腹部和胸骨前再次干预。本次手术干预的目的是确保肠内营养通路(胃造口术用于喂养)并切除胃食管成形管。文中讨论了该病例的特征:这种恶性疾病部位分期演变整合的困难、导致胃食管成形管胃窦部恶性演变的病因因素以及手术治疗的局限性。