管状胃重建在食管癌手术中的应用
The application of tubular stomach reconstruction in esophagectomy
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摘要: 目的:探讨管状胃在食管癌切除术中的应用效果。方法:将80例接受食管癌切除术的患者按不同术式分为2组,管状胃组40例行管状胃食管吻合术,全胃组40例采用传统全胃代食管吻合术。观察2组患者手术后肺部并发症、吻合口瘘、胸胃综合征、反流性食管炎发生率等临床指标。结果:2组均无手术死亡。管状胃组术后肺部并发症、反流性食管炎、胸胃综合征和无吻合口瘘的发生率分别为17. 5%、32. 5%12. 5%和0,全胃组分别为40. 0%、65. 0%. 32. 5和2. 5%。管状胃组的胸胃综合征、肺部并发症和反流性食管炎的发生率均低于全胃组(P0. 05~P0. 01);2组吻合口瘘发生率差异无统计学意义(0. 05)。结论:食管切除术后管状胃制作简单、安全,有效改善了胃食管反流,降低了胃排空不良的发生率,改善了患者术后生活质量。Abstract: Objective: To explore the application of tubular stomach reconstruction in esophagectomy. Methods: Eighty patients with esophageal carcinoma were devided into tubular stomach group and full stomach group according to different operation Methods( 40 cases each group) . The tubular stomach and whole stomach group were treated with tubular gastroesophagostomy and traditional whole gastroesophagostomy,respectively. The incidence of postoperative pulmonary complications,anastomotic fistula,thoracic stomach syndrome and reflux esophagitis in two groups were observed. Results: No death was found in two groups. The incidence of postoperative pulmonary complications, reflux esophagitis, thoracic stomach syndrome and anastomotic fistula in tubular stomach group and whole stomach group were 17. 5% & 40. 0%,32. 5% & 65. 0%,12. 5% & 32. 5% and 0% & 2. 5%, respectively. The incidence of postoperative thoracic stomach syndrome,pulmonary complications and reflux esophagitis in tubular stomach group were less than those in whole stomach group( P < 0. 05 to P < 0. 01) . The difference of the incidence of anastomotic fistula between two groups was not statistically significant( P > 0. 05) . Conclusions: The tubular stomach reconstruction in esophagectomy is simple and safe,which can improve gastroesophageal reflux, reduce the incidence of adverse gastric emptying and improve postoperative quality of life of patient.