胃经食管床颈部吻合食管癌根治术对术后呼吸功能的影响

Effects of the cervical esophagogastrostomy through esophageal bed for esophageal cancer on respiratory function

目的探讨胃经食管床颈部吻合食管癌根治术对患者术后呼吸功能的影响。方法60例食管胸中段癌患者。30例行食管癌切除胃经食管床颈部食管胃吻合术，30例行胸内食管胃弓上吻合术，测量比较术前、术后3周、3个月肺功能主要指标变化。结果患者均手术成功。颈部吻合组与胸内吻合组术前的肺活量（VC）、第1秒时间肺活量（FEV1）和最大通气量（MVV）差异均无统计学意义（P〉0．05）。术后3周、3个月两组相比VC、FEV1和MVV差异均有统计学意义（P〈0．05）。结论经食管床行食管胃颈部吻合对患者呼吸功能影响小。

Objective To evaluate the effect of cervical esophagogastrostomy through esophageal bed and the thoracic stomach after esophageetomy on respiratory function for patients with esophageal carcinoma. Method From March 2005 to September 2005, 60 patients with esophageal carcinoma in middle thoracic region underwent esophageetomy. 30 patients underwent cervical esophagogastrie anastomosis through esophageal bed while 30 patients were above aortic arch in upper aortic site. All patients were monitored respiratory function before operation, 3rd week and 3rcl month after operation. Results All patients were survival without any side effects. There was a significant difference between the esophagogastric anastomosis in neck and above the aortic arch. The VC, FVE1 and MVV at the postoperative 3rd week or 3rd month showed significant difference （P 〈0.05）. Conclusions After esophagectomy, cervical esophagogastric anastomosis through esophageal bed had litde effects on respiratory function than the esophagogastrostomy above aortic arch.