摘要
作者对47例胸段食管癌手术中保留迷走神经干行分组对比研究,其中保留神经组20例,常规手术对照组27例。保留组18例和对照组26例行根治性手术;余为姑息性手术。病理学检查发现保留组3例(15.0%)和对照组3例(11.1%)癌已浸润近迷走神经干或/和其分支附近;另外,保留组1例(5.0%)和对照组3例(11.1%),癌已侵及神经。基础胃酸分泌量(BAO)及胃排空时间(T1/2)测定:保留组BAO均数值(1.93mmol/h)和T1/2均数值(63.51分)与对照组BAO(0.75mmol/h)和T1/2(>105分)之间的差别皆显著;而与正常人组和术前对照组相比则差异无显著性意义。作者认为,术中保留迷走神经是可行的,术后胃的泌酸及运动功能损伤轻。但手术指征应限于T1~T2等较早期的病变,否则会影响手术的根治性。
Abstract The results of preserving vagal trunks in the
surgical treatment of 47 patients with the carcinomaof the thoracic
esophagus were discussed through a controlled study. There were 20
patients in thetest group with vagus nerve being preserved(PG) and 27
in the control group(CG) with vagus nervebeing routinely severed.
Eighteen patients in PG and 26 in CG underwent radical resections,
the re-maining ptients received palliative surgery. Pathological
findings showed that 3 cases (15.0%)in PGand 3 cases(11)in CG had
cancerous invasion near the vagal trunks and/or their main
branchsclose to the primary cancer; and 1 case(5.0%)in PG and
3(11.1%)in CG the vagal nerves wereactually invaded by cancer cells.
Determinations of basal gastric acid output(BAO)and half
gastricemptying time(T1/2)revealed that the mean value of
BAO.93mmol/h)and T1/2(63.51min.)of the PG were statistically
different from those of 0.75mmol/h and>105min. in CG , but similar
tothose of the healthy group and the preoperative control values. We
consider that it is feasible to pre-serve vagal trunks in the
operation and is beneficial in minimizing of postoperative
disturbances of gas-tric acid output and gastric motility; but the
indications of this procedure should only be limited toT1~T2 lesions
in order not to jeopardize the radicality of tumor resection.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
1995年第4期301-303,共3页
Chinese Journal of Oncology