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患者,男,47岁,因进行性吞咽困难四个月于1989年6月29日入院。入院前三周已不能进食,仅能进清流。18年前曾因十二指肠溃疡行胃大部切除,(结肠前)胃空肠吻合术。查体:消瘦,轻度贫血。Hb:112g/L,其余未见异常。食管钡餐检查:食管中下段有长约9.5cm狭窄,伴有粘膜破坏,钡通过受阻,上端食管明显扩张,诊断中下段食管癌。行食管癌切除、食管残胃弓下吻合术。手术后恢复顺利,一周后进食,咽下通畅,复查钡餐:吻合口通畅,直径约1.7cm。术后三周出院。 手术方式:取左胸后外侧切口,经第七肋
The patient, male, 47 years old, admitted to hospital on June 29, 1989 for four months of progressive dysphagia. Three weeks before admission, no food can be taken and only clear flow can be achieved. 18 years ago, he had had a gastrectomy for duodenal ulcer and an anterior gastrojejunostomy. Physical examination: weight loss, mild anemia. Hb: 112 g/L, and no abnormality was found in the rest. Esophageal barium meal examination: the middle and lower esophagus has a stenosis of approximately 9.5 cm, with mucosal destruction, obstruction through the obstruction, and obvious expansion of the upper esophagus to diagnose the middle and lower esophageal cancer. Esophageal cancer resection, residual esophageal bow under anastomosis. After the surgery, it recovered smoothly. After one week, it was eaten and swallowed. The barium meal was reviewed. The anastomosis was smooth and the diameter was about 1.7 cm. Three weeks after discharge. Surgical methods: Take left posterior lateral incision, through the seventh rib