鱼嘴状套叠缝合和保留迷走神经干在食管贲门癌手术中的应用

Application of fish head-shaped sleeve anastomosis plus retained vagus nerve truck in operations for esophageal and cardiac cancer

目的通过鱼嘴状套叠缝合和保留迷走神经干在食管贲门癌手术中的应用,探讨其在增加手术的安全性及提高患者术后的生活质量的作用。方法对196例食管癌、贲门癌患者施行吻合口鱼嘴状斜行套叠缝合加保留迷走神经干术(研究组),与对照组60例常规吻合方式的食管贲门癌手术对比分析。结果研究组的症状评估、食管pH值的测定、吻合口瘘的发生率等结果都明显优于对照组(P<0.05),两组比较差异有统计学意义。结论对食管、贲门癌患者施行吻合口鱼嘴状斜行套叠缝合和保留迷走神经干能有效降低胃食管返流、吻合口瘘、吸入性肺炎等并发症的发生率,增加了手术的安全性,提高了患者术后的生活质量。

Objective To apply fish head-shaped sleeve anastomosis plus retained vagus nerve truck in operations for esophageal and cardiac cancer in order to reduce complications and improve the postoperative life quality of patients.Methods Totally 196 patients with esophageal and cardiac cancer were enrolled and divided into study group（n=136） and control group（n=60）.Fish head-shaped sleeve anastomosis plus retained vagus nerve truck was applied in operations for study group while conventional anastomosis was adopted in operations for control group.Comparison was made after the operations.Results The symptom assessments,esophageal pH value and incidence of anastomotic fistula in study group were better than those in control group（P0.05）.Conclusion The application of fish head-shaped sleeve anastomosis plus retained vagus nerve truck in operations for esophageal and cardiac cancer can reduce the incidences of gastroesophageal reflux,anastomosis fistula and aspiration pneumonia.Meanwhile it will increase the safety of the operation and improve the postoperative life quality of patients.