Department of Cardiothoracic Surgery, Huashan Hospital, Fudan University, #12 Wulumuqi Rd. (M), Shanghai, 200040, P.R. China.
Department of Nursing, Huashan Hospital, Fudan University, Shanghai, P.R. China.
BMC Surg. 2023 Jun 27;23(1):175. doi: 10.1186/s12893-023-02072-w.
The aim of this study was to evaluate the feasibility and efficacy of simultaneous resection of synchronous advanced esophageal and gastric cancers.
We retrospectively analyzed the clinical data of 16 patients who underwent resection of synchronous advanced esophageal squamous cell carcinoma (ESCC) and gastric adenocarcinoma from January 2009 to Dec 2021. Subtotal esophagectomy and total gastrectomy were performed using the Ivor-Lewis or McKeown approach. Reconstruction was performed using a pedicled jejunal graft or colon interposition. Perioperative and postoperative data of all patients were analyzed.
There were no in-hospital mortalities following surgery, but 9 patients (56.3%) suffered major perioperative complications. Comparison of the groups that received reconstruction using the jejunum and the colon indicated similar incidences of perioperative complications, overall survival, and disease-free survival. Cox regression analysis indicated that lymph node metastasis of both cancers was independent risk factor for overall survival.
The existence of synchronous tumors of the esophagus and stomach is not unusual, the radical surgical treatment could be carried out whenever possible.
本研究旨在评估同时切除同步进展期食管和胃癌的可行性和疗效。
我们回顾性分析了 2009 年 1 月至 2021 年 12 月期间 16 例接受同步进展期食管鳞状细胞癌（ESCC）和胃腺癌切除的患者的临床资料。采用 Ivor-Lewis 或 McKeown 入路行全胃切除术和次全食管切除术。采用带蒂空肠移植或结肠间置术进行重建。分析所有患者的围手术期和术后数据。
术后无院内死亡，但 9 例（56.3%）发生重大围手术期并发症。比较使用空肠和结肠重建的两组，围手术期并发症、总生存率和无病生存率相似。Cox 回归分析表明，两种癌症的淋巴结转移是总生存率的独立危险因素。
食管和胃同时存在肿瘤并不罕见，只要有可能，就应进行根治性手术治疗。
