Matthews H R, Mitchell I M, McGuigan J A
Regional Department of Thoracic Surgery, East Birmingham Hospital, UK.
Br J Surg. 1989 Sep;76(9):918-20. doi: 10.1002/bjs.1800760915.
From 1981 to 1987 nine patients have undergone resection and reconstruction of the oesophagus as an emergency, using a two-part left-sided approach with oesophagogastric anastomosis in the neck. Five patients had oesophageal perforation with a carcinoma; one had spontaneous perforation of an intrathoracic stomach; two had severe haemorrhage; and one had acute sterile mediastinitis. Following operation there was one postoperative death (11 per cent) and no major complications. Long-term survival was marred only by the development of further malignancy in four patients. Subtotal oesophagectomy has both theoretical and practical advantages over conventional oesophagogastrectomy in oesophageal emergencies and we suggest that it should be considered as the method of choice in the management of these difficult cases.
1981年至1987年间，9例患者作为急诊接受了食管切除及重建手术，采用左侧两部分入路并在颈部行食管胃吻合术。5例患者因食管癌导致食管穿孔；1例患者为胸内胃自发性穿孔；2例患者发生严重出血；1例患者患有急性无菌性纵隔炎。术后有1例患者死亡（11%），无重大并发症。长期生存仅因4例患者出现进一步恶变而受到影响。在食管急诊中，次全食管切除术相对于传统食管胃切除术具有理论和实际优势，我们建议在处理这些疑难病例时应将其视为首选方法。
