27例食管癌切除术后胃排空障碍

Delayed Gastric Emptying After Esophagectomy for Patients with Esophageal Carcinoma

为探讨食管癌术后胃排空障碍合理的治疗方法及预防措施，对１９８２～１９９５年间２７例食管癌术后胃排空障碍病人的临床资料进行回顾性分析。食管胃颈部吻合者２２例，胸内吻合者５例。占同期食管癌手术２４２７例的１．１％。１８例功能性胃排空障碍病人中１５例经保守治愈，３例死亡；９例机械性胃排空障碍病人经手术治愈。结论：食管癌术后胃排空障碍好发于食管胃颈部吻合者，多为功能性，少数为机械性。因治疗方法不同需强调二者的鉴别诊断。术中精细适度各项操作。

Objective:To evaluate the incidence of delayed gastric emptying after esophagectomy and investigate reasonable methods to sure and prevent it.Clinica material and method:From 1982 through 1995,2427 patients with esophageal cancer underwent esophagectomy.27 patients with delayed gastric emptying after esophagectomy were studied.Result:The incidence of delayed gastric emptying after esophagectomy was 1.1%.There were 18 functional and 9 mechanical disorders.15 patients with functional gastric emptying disorder recovered with nonsurgical treatment.All the mechanically obstructive cases were treated surgically.Of the 27 patients with delayed gastric emptying,22 had esophagectomy with cervical anastomosis,5 had intrathoracic anastomosis.The mortality rate was 11.1%(3/27).Conclusion:Most of gastric emptying disorders were functional and often developed in the patients with cervical anastomosis.Because the obstructive cases required surgical intervention and the functional may be recovered with nonsurgical treatment,it is important to identify the different types.In order to prevent the obstructive gastric emptying disorder,surgical technique should be considered carefully during esophagectomy.