管状胃重建在食管癌手术中应用的临床研究

Clinical research of the gastric tube gastroesophagostomy of esophagectomy

目的探讨管状胃重建在手术治疗食管癌中的临床效果。方法自2009年1月至2009年12月,随机选择110例食管癌患者接受食管癌切除术,其中管状胃组54例行管状胃食管吻合术,全胃组56例采用传统全胃代食管吻合术。结果管状胃组发生胸胃坏死穿孔1例死亡,吻合口瘘2例保守治愈;全胃组发生吸入性肺炎死亡1例,吻合口瘘2例保守治愈,两组手术并发症比较差异无统计学意义,但术后生活质量管状胃组较全胃组有明显好转。结论管状胃重建更符合患者生理,术后远期生活质量明显提高。

Objective To evaluate the gastric tube gastroesophagostomy on clinical results after esophagectomy. Methods From January to December 2009,110 patients suffer esophageal carcinoma underwent esophagectomy. 54 patients underwent gastric tube gastroesophagostomy,the other 56 patients underwent whole stomach gastroesophagostomy. The postoperative complication were evaluated at earlier period. Results All patients were survival without hospitalization death. Postoperative complication showed one case stomach necrosis perforation,2 cases anastomotic leakage of gastric tube gastroesophagostomy group,and one case died of inhalation pneumonia, 2 cases anastomotic leakage of whole stomach gastroesophagostomy group. Postoperative complication rate showed no statistical significance between the gastric tube gastroesophagostomy and the whole stomach gastroesophagostomy group. Conclusion Gastric tube gastroesophagostomy are better coincidenced to anatomy and physiological functions,The long time life quality of gastric tube gastroesophagostomy group is obviously better than whole stomach gastroesophagostomy group.