食管、胃同时性多原发癌临床确诊时多属晚期,根治手术几无可能。我院曾手术治疗1例。病例摘要患者男、50岁。因上腹部阵发性疼痛半月于1986年10月15日拟诊为急性胆囊炎、胃炎入院。检查:T38℃,P80,BP90/60,巩膜无黄染,两锁骨上淋巴结(一)。腹软,剑突下及胆囊区压痛(-)。两次“B”超检查,胆囊及胆道未见明显异常。上消化道钡餐检查:发现中段粘膜破坏,局部管腔不完整。胃窦小弯侧可见约1.0×0.5cm之龛影,其周围有不规则充盈缺损,局部粘膜破坏,蠕动消失,幽门管能开放。印象为1.食管中段癌;2.胃窦区小弯侧溃疡型癌。又行纤维胃镜检查证实两处确有病变,分别取活检。病理报告,食管中段低分化鳞癌;胃窦部腺癌。于1986年11月25日行食管、胃同时性多原发癌切除术,1.上腹正中切口,网膜、肝脏等未见转移灶,胃窦小弯侧6×4×4cm癌瘤,遂行胃大部切除,胃-空肠端侧吻合;2.非经胸食管内翻拔脱,左颈部食管切除;再行横结肠,与颈部食管及残胃端端、端侧吻合;升、降结肠行 Simultaneous multi-primary cancer of the esophagus and stomach is mostly diagnosed at the time of clinical diagnosis, and radical surgery is almost impossible. Our hospital had surgery in 1 case. Case summary Patient male, 50 years old. Due to paroxysmal pain in the upper abdomen on October 15, 1986, she was diagnosed with acute cholecystitis and gastritis. Check: T38°C, P80, BP90/60, sclera without yellow stain, two supraclavicular lymph nodes (1). Abdominal soft, xiphoid and gallbladder area tenderness (-). Two “B” ultrasonographs showed no obvious abnormalities in the gallbladder and biliary tract. Upper gastrointestinal barium meal examination: It was found that the middle mucosa was damaged and the partial lumen was incomplete. The small antrum curvature side can be seen about 1.0 × 0.5cm of the shadow, around its irregular filling defect, local mucosal damage, peristalsis disappeared, pylorus can open. The impression is 1. Middle esophageal cancer; 2. Gastric sinus area of ​​small curved side ulcer type cancer. Fiberoptic gastroscopy was performed again to confirm that there were lesions at two sites and biopsy was performed. Pathology report, poorly differentiated squamous cell carcinoma in the middle esophagus; adenocarcinoma of gastric antrum. On November 25, 1986, a simultaneous excision of multiple esophageal and gastric cancers was performed. 1. Upper midline incision, omentum, liver, etc. No metastatic lesions, 6×4×4 cm carcinoma of antrum small curvature. The subtotal gastrectomy was performed and the gastro-jejunal end-to-side anastomosis was performed; 2. Esophageal resection was performed in the absence of transesophageal esophageal inversion and left neck; and the transverse colon was performed again, and the end of the esophagus and remnant stomach of the neck was anastomosed; Descending colon line