管状胃与全胃重建食管治疗食管癌的疗效分析

Curative effect analysis of tubular stomach and whole stomach reconstruction for esophageal cancer

目的 探讨管状胃与全胃重建食管治疗食管癌的疗效.方法 将280例食管癌手术患者按手术方式不同分成管状胃组（116例）和全胃组（164例）,回顾性分析两组患者术后并发症、生存质量及生存时间的差异.结果 管状胃组和全胃组术后前3d胃肠减压管引流量分别为第1天（120±55） ml、（220±60） ml,第2天（80 ±28） ml、（190±50） ml,第3天（65±32） ml、（260±80） ml,两组相比,差异有统计学意义;术后1周反流性食管炎发生率分别为35.2％ （41/116）和66.4％（109/164）,P＜0.05;术后1年生存质量满意率分别为82.7％（96/116）和53.3％（109/164）（P＜0.05）;而在术后肺部并发症、1年复发率、吻合口瘘、吻合口狭窄方面差异无统计学意义（P＞0.05）.结论 食管癌根治手术中,管状胃组疗效要优于全胃手术组.

Objective To compare the clinical effects of tubular stomach and whole stomach reconstruction for esophageal cancer.Methods According to the surgical procedures,280 patients with esophageal cancer were divided into tubular stomach group（n =116）and whole stomach group（n =164）.The differences of postoperative complications,quality of life and survival time were retrospectively analyzed.Results The drainage volumes of gastrointestinal decompression were （120 ± 55） ml and （220 ± 60） ml at the first day （P ＜ 0.05）,（80 ± 28） ml and （190 ± 50） ml at the second day （P ＜ 0.05）,and （65 ± 32）and（260 ± 80）at the third day （P ＜ 0.05）.One week after operation,the incidence of reflux esophagitis in the tubular stomach group and whole stomach group were 35.2％ （41/116） and 66.4％ （109/164） （P ＜ 0.05）.One year after the operation,the tubular stomach group was more satisfactory （82.7 ％,96/116） about quality of life than the whole stomach group （53.3 ％,109/164） （P ＜ 0.05）.No differences were found in the rates of postoperative pulmonary complications,recurrence in the first year,anastomotic fistula and anastomotic stenosis （P ＞ 0.05）.Conclusion The clinical effect of tubular stomach was better than that of the whole stomach in the radical operation for esophageal cancer.