管状胃在食管胃吻合术中的疗效观察

Clinical effect of tubular stomach in esophagogastrostomy

目的探讨食管癌根治术中更为有效的食管胃吻合技术。方法选择2013年1月至2015年12月食管癌根治手术患者188例,将其随机分为管胃组(实验组)104例和全胃组(对照组)84例。比较分析两组患者年龄、性别、肿瘤分期、吻合方法、胃液引流量、手术时间,以及吻合口瘘、吻合口狭窄、胃食管反流、胃排空延迟、胸胃综合征的发生率等术后并发症和生活质量指标。结果两组患者均痊愈出院。实验组与对照组术后胃排空功能及胸胃综合征比较差异有统计学意义(P<0.05),而年龄、性别、肿瘤分期、吻合方法、胃液引流量、手术时间和吻合口瘘、吻合口狭窄及反流性食管炎比较差异未见统计学意义(P>0.05)。结论食管癌根治术中应用管状胃代替食管更符合生理,可明显改善术后患者的生活质量。

Objective To explore the efficacy technique of gastric tube in esophagectomy. Methods From January 2013 to December 2015,188 patients who underwent esophagectomy were performed. The patients were divided into two groups including104 cases of tubular gastric reconstruction esophagectomy（ experimental group） and 84 cases of whole stomach reconstruction esophagectomy（ control group）. Comparisons were achieved for postoperative complications and life quality index,such as age,sex,stating,anastomotic type,gastric drainage volume,operation time,and the rate of anastomotic leakage,anastomotic stenosis,gastroesophageal reflux,delayed gastric emptying and thoracic-gastro syndrome between two groups. Results All of the two groups were cured. Significant differences were observed in delayed gastric emptying（ P〈0. 05） and thoracic-gastric syndrome（ P〈0. 01） between the two groups,however,no difference in age,sex,stating,anastomotic type,gastric drainage volume,operation time,anastomotic leakage,anastomotic stenosis or gastroesophageal reflux（ P〉0. 05）. Conclusion Tubular stomach replacing esophagus in esophagogastrostomy more accord with physiology,significantly improving the quality of life of postoperative patients.