ABSTRACT
Objective To explore the feasibility of gastroesophagostomy when patients with esophagus carcinoma com bined with stomach carcinoma.Methods In March 2011 to May 2016,our department completed with the method of genera tion of esophagus stomach in the treatment of esophageal cancer merger 18 cases of gastric cancer patients.Age 52-67,16 ca ses of esophageal lesions located in the middle section,2 cases located in the chest.4 cases were gastric lesions located in the proximal stomach,14 cases were located in the distal stomach Four kinds of surgical methods can be chosen from.Proximal or distal stomach could be used to replace esophagus and the blood supply came from left gastric artery or right gastroepiploic artery.Stomach tissue separation and reverse gastric tube were used if the length of stomach was insufficieut.Results When resection of esophageal and gastric carcinoma were accomplished simultaneously,residue stomach can be used as a replacement of esophagus if patients were rigidly selected.Conclusion Residue stomach was a good substitute after radical resection of esoph agus and gastric dual-source carcinoma.Patients chosen and surgery design were both important.
ABSTRACT
Objective To explore the feasibility of gastroesophagostomy when patients with esophagus carcinoma com bined with stomach carcinoma.Methods In March 2011 to May 2016,our department completed with the method of genera tion of esophagus stomach in the treatment of esophageal cancer merger 18 cases of gastric cancer patients.Age 52-67,16 ca ses of esophageal lesions located in the middle section,2 cases located in the chest.4 cases were gastric lesions located in the proximal stomach,14 cases were located in the distal stomach Four kinds of surgical methods can be chosen from.Proximal or distal stomach could be used to replace esophagus and the blood supply came from left gastric artery or right gastroepiploic artery.Stomach tissue separation and reverse gastric tube were used if the length of stomach was insufficieut.Results When resection of esophageal and gastric carcinoma were accomplished simultaneously,residue stomach can be used as a replacement of esophagus if patients were rigidly selected.Conclusion Residue stomach was a good substitute after radical resection of esoph agus and gastric dual-source carcinoma.Patients chosen and surgery design were both important.
ABSTRACT
Objective To explore the clinical characteristics and related factors of Helicobacter pylori (Hp) infection in gastric stump lesion.Methods Eighty-nine patients with subtotal gastrectomy gastrointestinal symptoms underwent gastroscope,the clinical data were retrospectively analyzed.The relationship between gastric Hp infection and different operation reasons,different operation,different degree of inflammation,postoperative time,the existence of bile reflux was assessed.Results There were 29 cases of gastric Hp infection,the positive rate of Hp was 32.6％ (29/89).There were no significant difference between different preoperative disease such as duodenal ulcer (bleeding/perforation),gastric ulcer (bleeding/perforation),gastric cancer,leiomyosarcoma and HP infection (P ＞0.05).There was no significant different positive rate of Hp infection between Billroth Ⅰ and Billroth Ⅱ after operation (P ＞0.05).The rate of Hp infection increased with the degree of inflammation (moderate to severe) in gastric stump and anastomotic inflammation.There were significant difference [gastritis severity of inflammation:27.3％ (12/44) vs.57.1％ (16/28),anastomotic inflammation:25 ％ (10/40) vs.50％ (18/36),P ＜ 0.05] ;there was significant difference between two groups of more than 10 years [43.9％ (18/41)] and less than 10 years [22.9％ (11/48)] of Hp infection rate (x2 =4.433,P =0.035) ; the positive rate of Hp infection in group of no bile reflux under gastroscopy were higher than the group of bile reflux,there was significant difference [22.2％ (10/45) vs.43.2％ (19/44),x2 =4.449,P =0.035).Multivariate Logistic regression analysis showed that,the degree of inflammation (severe) and bile reflux was associated with gastric Hp infection,inflammation (severe) was the dominant risk factor [OR =1.24,95％ CI:1.22-1.56,P =0.01],with bile reflux were protective factors [OR =0.76,95％CI:0.58-0.99,P =0.04].Conclusions Hp infection can promote and aggravate the gastric remnant mucosa inflammation,Hp infection and bile reflux can lead to gastric mucosa pathological changes,there can be independence pathogenic factors,also can cause at the same time,regulate the eradication of residual gastric Hp infection is very important,also deal with the residual stomach regular line of gastroscope and Hp,histologic examination.