食管胃底静脉曲张破裂出血经硬化剂治疗后食管狭窄合并贲门癌一例
Esophageal stricture complicated with cardia cancer after endoscopic injection sclerotherapy for esophago-gas-tric fundal varices rupture bleeding:a case report
江素鑫 1王怀宇 2蒲猛 2刘承利 2韩勇2
作者信息
- 1. 110122 沈阳,中国医科大学研究生院;100142 北京,空军特色医学中心
- 2. 100142 北京,空军特色医学中心
- 折叠
摘要
贲门癌合并肝硬化、脾功能亢进、门静脉高压的患者因肝功能较差,往往存在化学治疗等全身用药禁忌,外科手术成为这类贲门肿瘤患者的治疗首选方案.手术适应证的评估、手术方案的优化和围手术期管理策略成了这类手术安全、成功实施的关键.该文报道1例65岁男性患者同期实施腹腔镜巨脾切除、贲门周围血管离断联合左开胸贲门癌根治术,术后恢复满意,2周可半流饮食,术后随访1年余,患者一般情况良好,能正常饮食,白细胞、红细胞、血小板减少已纠正,肝功能正常,门静脉超声未见血栓形成.该例提示对于贲门恶性肿瘤合并肝硬化、脾功能亢进、食管胃底静脉曲张及食管狭窄的复杂病情的患者,该手术方式提供了新的治疗思路,可以成为一种安全、有效的手术治疗选择.
Abstract
Cardia cancer patients complicated with cirrhosis,hypersplenism,and portal hypertension constantly have contraindications to systemic drugs such as chemotherapy due to poor liver function,and surgery has become the preferred treatment for patients with such cardia tumors.Evaluation of surgical indications,optimization of surgical regimen,and perioperative management strategy are key factors for safe and successful implementation of these surgeries.Here,we reported a 65-year-old male patient undergoing laparoscopic splenectomy plus pericardiac vascularization combined with radical resection of cardiac carcinoma.Satisfactory clinical efficacy was obtained.He could eat semi-liquid diet at 2 weeks after surgery.During over 1-year follow-up,the patient was generally in good condition,could eat normal diet,and the white blood cell,red blood cell and platelet were restored normal.Liver function was normal,and no thrombosis was seen on portal ultrasound.This case prompts that for cardia cancer patients complicated with cirrhosis,hypersplenism,esophago-gas-tric fundal varices,esophageal stricture,this surgical regimen provides novel therapeutic ideas,which can be utilized as a safe and effective treatment option.
关键词
肝硬化/脾功能亢进/食管狭窄/贲门癌/食管胃底静脉曲张Key words
Cirrhosis/Hypersplenism/Esophageal stricture/Cardia cancer/Eesophago-gas-tric fundal varices引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据