ABSTRACT
ObjectiveTo discuss the surgical treatment for patients with anastomotic stoma cancer,gastric cardial cancer or esophagus cancer after subtotal gastrectomy.MethodsThe clinical data of 21 patients with anastomofic stoma cancer,gastric cardial cancer or esophagus cancer after subtotal gastrectomy were analyzed retrospectively.There were 4 cases with anastomotic stoma cancer after operation of gastric cardial cancer,2 cases with gastric cardial cancer after subtotal gastrectomy due to gastriculcer,3 cases with upper esophagus cancer after subtotal gastrectomy due to gastric ulcer,6 cases with mid-esophagus cancer and 6 cases with distal esophagus cancer after subtotal gastrectomy due to gastric ulcer.There were 6 cases treated with partial esophagus resection,resection of remaining stomach and jejuna-esophagus anastomosis,3 cases treated with partial esophagus and stomach resection and esophagus-gastric anastomosis,12 cases with subtotal esophagectomy and colon interposition.ResultsOne case with incision infection,1 case with anastomosis leaks,1 case dead of pulmonary infection.In the 20 follow-upcases,4 cases were dead of cardiac and cerebral accidents at the third year after operation,and other 16 cases survived and had normal diet.ConclusionsReoperation is still one of the best choices for patients with anastomotic stoma cancer,gastric cardial cancer and esophagus cancer after subtotal gastrectomy when their body condition are acceptable and without distant metastasis.The organ for digestive tract reconstruction should be decided according to the situation of the first gastrectomy and the proficiency of the operator.
ABSTRACT
Objective To evaluate the effect of esophagogastric intramural implantation anastomosis after esophagectomy. Methods One thousand and two hundred thirty-six patients with esophageal and cardial cancers were treated by esophagogastric intramural implantation anastomosis after esophagectomy. The mucosal layer, the esophageal and gastric muscular layers were on three different levels after the anastomosis. Results Among 1236 patients, 842 cases were esophageal cancer,and 394 cases were cardial cancer.The anastomoses were performed in different levels including 15 cases below the pharynx, 193 cases on neck,634 case above the aortic arch and 394 cases below the aortic arch. One of the patients died 24 hours after the operation due to myocardial ischemia, and two of them died of respiratory failure. Anastomotic leakage, stenosis and refluxing esophagitis did not appear in this series. Conclusions Esophagogastric intramural implantation anastomosis can decrease the incidence of anastomotic leakage, stenosis and refluxing esophagitis after esophagectomy.