食管粘膜层经隧道食管胃吻合术的临床研究

A Clinical Study of Esophagogastrostomy by Esophageal Mucosal Layer Through Gastro muscular Layer Tunnel

目的食管癌手术后吻合口瘘和吻合口狭窄的并发症已明显下降，而反流性食管炎已成为影响术后患者生活质量的主要并发症。为此设计了食管粘膜层经胃壁肌层下隧道行食管胃吻合术。方法食管粘膜层经隧道食管胃吻合术１７５例，其中２０例与同期隧道式食管胃吻合术２０例进行对比研究。术后６～１２个月，行食管压力测定、食管镜检查、组织活检和食管内反流液ｐＨ值测定。结果２组患者术后均无吻合口瘘发生，无手术死亡。结论该术式具有明显地抗反流作用。

Objective The incidence of anastomotic leakage and stenosis as the postoperative complications of esophageal carcinoma has been dropped markedly, while the reflux esophagitis still is the major complication that influence the life quality of patient. To resolve this problem, we have developed a new mode of esophagogastrostomy by esophageal mucosal layer through gastro muscular layer tunnel. Methods 20 in 175 cases of esophagogastrostomy by esophageal mucosal layer through gastro muscular layer tunnel and 20 cases of tunnel esophagogastrostomy as the control group entered the study. The determination of intraluminal esophageal pressure, the esophagoscopic examination and biopsy, and the determination of pH level of esophageal reflux fluid were carried out 6 12 months after the operation. Results No anastomotic leakage occured on both groups after the operation, nor death occured due to operation. Conclusion This mode of operation can markedly prevent the postoperative reflux of gastric juice, thus preventing the incidence of reflux esophagitis.