不同术式食管癌术后残胃瘘临床分析

Comparative study on remnant stomach leakage with and without gastric tube in patients after radical resection of esophageal carcinoma

目的分析不同术式食管癌术后残胃瘘的发生率及治疗方法。方法对比分析管状胃组和对照组中残胃瘘和吻合口瘘的发生率,对发生瘘的患者采用积极的综合治疗并进行回顾性分析。结果残胃瘘发生率管状胃组和对照组差异有显著性(5.1%vs.1.6%,P<0.05),吻合口瘘发生率管状胃组和对照组差异无显著性(3.0%vs.3.2%,P>0.05)。22例发生瘘的患者均痊愈出院,无1例死亡。结论管状胃组残胃瘘发生率较对照组高,多与残胃损伤导致血运、氧合不佳有关,及时发现并妥善处理可促进瘘口愈合,显著降低瘘的死亡率。

[ Objective ] To analyze the rates and therapeutic methods of remnant stomach leakage with and with- out gastric tube in patients with esophageal carcinoma. [Methods ] The rates of remnant stomach leakage and anas- tomotic leakage in the gastric tube group and in the control were compared. The leakage suffers were treated with combined modality therapy. The curative effect was analyzed retrospectively. [ Results ] There was significant differ- ence in remnant stomach leakage between the gastric tube group and the control （5.1% vs. 1.6%, P 〈0.05）, and no significant difference was observed in anastomotic leakage （3% vs. 3.2%, P 〉0.05）. All the 22 leakage suffers were cured by the combined treatments. [ Conclusions ] There was higher incidence of remnant stomach leakage in the gastric tube group compared to the control, which was relevant to ischemia and oxygen-poor in injured remnant stomach. Early diagnosis and well treatment contribute to the cure of orificium fistulae and the significant reduction of death rates of leakage.