复杂食管癌外科治疗进展.docVIP

复杂食管癌的外科治疗进展 　　[摘要] 复杂食管癌是指切除困难和/或切除后消化道重建困难常规手术无法治疗的食管癌。本文将复杂食管癌分为三类：部位复杂，颈段食管癌；病变复杂，双源癌（食管癌合并胃癌）；病史复杂，残胃食管癌。复杂食管癌患者的手术是一种跨学科的治疗方法，手术涉及喉、咽、食管和胃肠的切除与功能重建，与普通食管癌相比，复杂食管癌具有临床少见、手术操作复杂、治疗经验相对不足等特点。手术医生根据各自的经验选择不同的手术方式，每种手术方式都有各自的优缺点，至今尚无统一的手术方式，对其外科治疗无法开展前瞻性的临床研究，只能根据少数的个例治疗经验和个体病变寻求最佳各治疗方案。本文对三类复杂食管癌的常见手术方式的优缺点及术后并发症情况分别进行阐述，总结各种手术经验，以供临床参考 [关键词] 复杂食管癌；消化道重建；颈段食管癌；双源癌；残胃食管癌 [中图分类号] R735.1 [文献标识码] A [文章编号] 1674-4721（2016）10（c）-0060-04 [Abstract] Complex esophageal cancers are defined as what are difficult to be resected， reconstructed or cured by traditional operation methods. In this paper， complex esophageal cancers are divided into three categories： those located in complex site and cervical esophagus carcinoma， those with complicated lesions and concurrent gastrointestinal cancers， those with complicated history and esophageal cancer after distal gastrectomy. The surgery methods of complex esophageal cancers are interdisciplinary treatments， involving the throat， pharynx， esophagus， and gastrointestinal surgery resection and function reconstruction. Compared with conventional esophageal cancers， complex esophageal cancers have its characteristics， such as rarity in clinic， complexity for surgical treatment， inexperienced treatment and so on. Each operation has its advantages and drawbacks， so most surgeons choose different operation procedures according to their own experiences. For surgical treatment of complex esophageal cancers， prospective clinical studies can’t be carried out. The best therapeutic schedules can only rely on experiences of small case series and case reports. This paper reviews the characteristics and complications of different surgical methods of complex esophageal cancers and summarizes the treatment experiences for clinical practice. [Key words] Complex esophageal cancer； Digestive tract reconstruction； Cervical esophagus carcinoma； Synchronous esophageal and gastric carcinomas； Esophageal cancer after distal gastrectomy 食管癌是高发恶