人工胃底折叠重建His角的抗反流作用——附食管胃连接部癌102例分析

The anti-reflux function of rebuilding His angle through artificially folding gastric fundu ——A clinical study of 102 cases with esophagogastric junction cancer radical operation

目的探讨人工胃底折叠重建His角预防食管胃连接部癌根治术后吻合口反流的价值。方法食管胃连接部癌根治术中利用人T胃底折叠重建His角,使其接近恢复食管胃连接部的生理解剖。术后通过上消化道造影及胃镜检查来评定其抗反流效果。结果实验组51例,无手术死亡,无吻合口狭窄及吻合口瘘,上下切缘均无癌残留。其中6例有反流症状,反流发生率11.8%;对照组51例,有反流者22例,反流发生率43.1%。两组反流发生率差别有统计学意义(P<0.001)。结论该术式具有较好的抗反流作用,且具有操作简单、安全等优点。

Objective To study the value of rebuilding the His angle through artificially folding gastric fundus to prevent stoma reflux after radical operation of esophagogastric junction cancer（EGJC）. Methods To approach physiological anatomy, the His angle was rebuilding by artificially folding gastric fundus during the operation of EGJC, and its effect of anti-reflux was assessed by opacification in upper gastrointestinal and gastroscopy after operation. Results 51 cases of experimental group had no operative death, no anastomosis stricture and leakage, no residual cancer at upper and lower margin. Only 6 cases had reflux symptoms, the reflux rate was 11.8%. In 51 cases of control group, there were 22 cases who had the reflux symptoms, the reflux rate was 43.1%. There was significant difference between two groups （P 〈 0. 001 ）. Conclusions This procedure has many advantages such as anti-reflux, simplicity and safty.