胃管状成形重建食管手术治疗食管癌410例临床分析

The Clinical Analysis of Gastric Tube Construction in Esophageal Reconstruction for the Therapy of 410 Cases of Esophageal Carcinoma

目的:探讨胃管状成形重建食管手术治疗食管癌的临床应用效果。方法:410例食管癌患者行胃管状成形重建食管手术,其中92例在颈部行胃-食管吻合,318例在胸内行胃-食管吻合。术中测量做管状胃前的胃和管状胃的长度。观察手术时间、术中出血量、术后胃液引流量和内容、胸液引流量、术后输血量和围手术期对呼吸的影响、胃排空及反流等并发症发生的情况。结果:410例患者均治愈出院。手术时间、术中及术后输血未增加,围手术期未发生胸胃综合征,无术后胃出血、胃排空障碍和反流。无手术死亡。结论:胃管状成形重建食管术式符合生理解剖要求,减少了胸胃综合征症状和反流,提高了患者的生存质量。

Objective： To investigate the clinical effect of gastric tube construction in esophageal reconstruction for the therapy of esophageal carcinoma. Methods： For 410 esophageal carcinoma patients with gastric tube construction therapy, we performed cervical esophagogastrostomy in 92 patients and thoracal esophagogastrostomy in 318 patients. The length of original stomach and gastric tube were measured during operations. We also observed operation time and blood lose during operation; gastric juice drainage volume and contents, chest fluid drainage volume and blood transfusion volume after operation; respiration, gastric emptying and reflux complication during perioperative time. Results： All the 410 patients were cured.. Operation time and blood infusion did not increase. There was no thoracic-gastro syndrome, postoperative gastrorrhagia, gastric emptying disorder, reflux and death after operation. Conclusion： Gastric tube construction in esophageal reconstruction consists with physiological anatomy. It can reduce thoraeic-gastro syndrome and reflux, thus improve the life quality of patients.