管胃成形术在食管癌手术中的临床研究

Clinical study of reconstruction of esophagus with gastric tube for carcinoma of esophagus

目的观察胃管状成形术在食管癌手术中的应用,探讨其对食管癌术后并发症的影响。方法回顾性分析本科2008年9月～2011年9月手术治疗的360例食管癌病例,其中行管胃重建消化道122例,传统全胃重建消化道238例,对两组术后并发症进行对比分析。结果两组患者均康复出院,无死亡病例。管胃组吻合口瘘发生率为0,全胃组(对照组)为4.20%;管胃组吻合口狭窄发生率为3.27%,全胃组为9.66%;管胃组反流性食管炎发生率为5.74%,全胃组为15.97%;管胃组胸胃综合征发生率为0,全胃组为5.04%;管胃组胃排空延迟发生率为1.64%,全胃组为7.56%。管胃组并发症发生率明显低于全胃组,差异均有统计学意义(P<0.05)。结论管胃重建消化道更加符合生理解剖要求,并发症发生率明显降低,患者术后生活质量明显改善。

Objective To evaluate the application during esophagectomy and the effect of gastric reconstruction with tubi- form stomach to postoperative complications. Methods Three hundred and sixty cases of patients of esophageal carcinoma were divided into gastric tube group and total gastric group. Postoperative complications between two groups were compared. Results All patients were recovered after operation. The incidences of anastomotic fistula, stoma stenosis, reflux esophagitis, thoracic stomach syndrome and delayed gastric emptying of tubiform stomach group were less than those of total gastric group, accounting for 0 vs 4.20%, 3.27% vs 9.66%, 5.74% vs 15.97%, 0 vs 5.04%, 1.64% vs 7.56%, the differences were statistical significance （P 〈 0.05）. Conclusion The gastric tube reconstruction with tubiform stomach accords with physiolgicoanatomical function of the digestive tract. It can reduce the postoperation complications and improve the postoperative quality of life.