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不可切除食管癌的旁路手术联合输注治疗

[By-pass surgery with infusion therapy for non-resectable esophageal cancer].

作者信息

Namatame K, Kataba Y, Okamura R, Yoshida K, Watanabe H, Yanagawa C

出版信息

Gan To Kagaku Ryoho. 1985 Jul;12(7):1502-9.

PMID:2409927
Abstract

In principle, the following three steps are considered for by-pass surgery; I. A gastric tube is moved up to the retro-sternal or to the ante-thoracic position. A T-tube is the inserted in the mid position of the gastric tube for decompression and drainage. 2. A retention vinyl tube is inserted in to the excluded esophagus for the purpose of post infusion therapy and for evaluation of the therapy. 3. A Roux-Y anastomotic internal fistula is placed at the distal site of the excluded esophagus. As a plan for combined therapy, PANa-Oil bleomycin (oil bleomycin 30 mg, PANa 0.5 g) is the infused into the isolated esophagus after the by-pass operation and the clinical effect is evaluated by introducing a radiopaque medium into the excluded esophagus via an inserted vinyl tube. Such infusion therapy after by-pass surgery was given to 3 patients and in 1 patient it was very effective. This suggested a positive effect on survival in cases of non-resectable esophageal cancer without side effects.

摘要

原则上,旁路手术需考虑以下三个步骤:一、将胃管上移至胸骨后或胸前位置。在胃管中部插入T形管用于减压和引流。二、将一根留置的乙烯基管插入被排除的食管,用于术后灌注治疗及评估治疗效果。三、在被排除食管的远端部位建立Roux-Y吻合内瘘。作为联合治疗方案,在旁路手术后将平阳霉素油悬液(平阳霉素30mg,平阳酸钠0.5g)注入孤立的食管,并通过插入的乙烯基管将不透X线的介质引入被排除的食管来评估临床效果。3例患者接受了这种旁路手术后的灌注治疗,其中1例效果非常显著。这表明对不可切除食管癌患者的生存有积极作用且无副作用。

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