贲门癌手术中斜行套叠再造胃底His角的抗反流远期效果观察

Long-time effect of gastric cardia cancer with oblique intussusceptive His recycling angle in preventing gastroesophageal reflux

目的研究贲门癌手术中斜行套叠再造胃底His角的抗反流远期效果。方法选取120例贲门癌患者随机分为试验组和对照组,每组60例。试验组患者给予斜行套叠再造胃底His角术,对照组患者给予单纯机械吻合术,观察两组患者手术后12个月的食管反流及反流性食管炎发生情况。结果试验组患者24h胃肠功能动态pH<4的时间占监测总时间的百分率、pH<4的反流次数、>5min的反流次数和最长反流时间均明显低于对照组患者。试验组患者反流性食管炎0级比例明显高于对照组患者,差异均有统计学意义(P<0.01)。结论斜行套叠再造胃底His角治疗贲门癌能有效阻止反流的发生,减少术后反流性食管炎的发生率。

Objective To study long-time effect of gastric cardia cancer with oblique intussuscep- tive His recycling angle in preventing gastroesophageal reflux. Methods On hundred and twenty patients with gastric cardia cancer were randomly divided into experimental group and control group, each group had 60 patients. Patients in experimental group were given the oblique intussusceptive His recycling angle, pa- tients in control group were given a simple mechanical anastomosis. EsoPHageal reflux and reflux esoPHagi- tis situation were observed after 12 months. Results PH 〈 4 time accounting for the percentage of total mo- nitoring time, PH 〈 4 of reflux episodes, more than 5rain of reflux episodes and the longest time of reflux in experimental group were significantly lower than that in the control group. The proportion of patients in the 0 grade was significantly higher in the experimental group, the differences were statistically significant （ P 〈 0. 01 ）. Conclusion Oblique intussusceptive His recycling angle can effectively prevent the occurrence of reflux, reduce postoperative reflux esophagitis in treatment of gastric cardia cancer.