Department of Surgery, University Hospital, RWTH, Aachen, Germany.
Surgery. 2010 Apr;147(4):491-6. doi: 10.1016/j.surg.2009.10.045. Epub 2009 Dec 11.
In patients with esophageal cancer and a history of gastric surgery, colonic interposition is the treatment of choice. Our aim was to review our experience with this technique and to identify possible predictors of the clinical outcome.
Between 1986 and 2006, 43 patients underwent esophageal reconstruction accomplished by colon interposition in our surgical department. Data from these patients were collected consecutively and reviewed retrospectively.
Colon interposition was performed isoperistaltically in 15 patients and was performed in 28 patients anisoperistaltically. In 18 patients, the right colon was used for interposition, whereas in 25 patients, the left colon was used. The mean survival time was 23+/-29 months. Artificial ventilation more than 24h, tumor differentiation grade III, the presence of major complications, and the presence of multivisceral resection had a significant negative influence on the operative outcome of colon interposition for esophageal replacement.
Colon interposition for esophageal replacement provides a satisfactory operative outcome with high complication rates. Therefore, it should be reserved as a treatment of second choice for cases in which the stomach is not available.
对于有胃外科手术史的食管癌患者，结肠间置术是首选的治疗方法。我们旨在总结我们应用该技术的经验，并明确该术式临床结果的可能预测因素。
1986 年至 2006 年间，我们外科部门对 43 例患者实施了结肠间置术进行食管重建。连续收集这些患者的数据，并进行回顾性分析。
15 例患者行顺蠕动结肠间置术，28 例患者行逆蠕动结肠间置术。18 例患者使用右半结肠，25 例患者使用左半结肠。平均生存时间为 23+/-29 个月。人工通气超过 24 小时、肿瘤分化程度 III 级、发生严重并发症以及合并多脏器切除与结肠间置术治疗食管重建的手术结果有显著的负性影响。
结肠间置术用于食管重建可获得令人满意的手术结果，但并发症发生率较高。因此，该术式应作为胃不可用时的二线治疗选择。
