管状胃在食管癌切除术中的应用研究

Clinical application of tubular stomach in esophageal cancer resection

目的 探讨管状胃在食管癌切除术中的临床应用及对术后生活质量的影响。方法 对100例食管癌和食管胃交界癌切除用管状胃重建上消化道患者资料进行回顾性分析,探讨管状胃的制作方法及该术式在防止并发症方面的优势。结果 本组100例患者中,术后发生吻合口瘘2例,肺部感染2例,心律失常3例,吻合口狭窄2例,均经保守治疗治愈,无乳糜胸、喉返神经损伤及胸胃排空障碍发生。随访85例,随访时间8～24个月,无胸胃综合征及明显反流性食管炎等并发症发生。结论 食管切除术后管状胃制作简单、安全,形态及生理上与食管相似,有更长的替代长度,保证了更好的血运;最大限度切除了胃的泌酸面积,改善了胃食管反流;降低了胃排空不良的发生;改善了患者术后生活质量。

Objective To explore clinical application and it＇s impact on postoperative quality of the tubular stomach in esophageal resection. Methods Data of 100 cases of esophageal cancer and gastroesophageal junction cancer resection with gastric reconstruction patients with upper digestive tract were retrospectively analyzed, the production method of tubular stomach and the surgical advantages in the prevention of complications were focussed. Results Of 100 patients, there were postoperative anastomotic fistula 2 cases,lung infection 2 cases, arrhythmia 3 cases, anastomotic stenosis 2 cases, all of which were cured by conservative treatment. There were no chylothorax and throat back to nerve injury and delayed gastric emptying occurred chest. 85 cases were followed up 8 to 24 months, there were no significant thoracic stomach syndrome and reflux esophagitis complications found. Conclusion Production of tubular stomach after esophagectomy is simple and safe. In morphology and physiology it is more similar to esophagus, with a longer alternative length which can ensure a better blood supply, achieve the maximum removal of acid secretion area in the stomach ; so as to improve gastroesophageal reflux and reduce the incidence of adverse gastric emptying so as to improve the patient＇s postoperative quality of life.