残胃食管癌患者应用带蒂空肠食管高位吻合手术治疗的可行性探讨

Feasibility of Pedicled Jejunal Esophagus High Anastomosisoperation for Patients with Remnant Stomach Esophagus Cancer

目的:探讨残胃食管癌患者应用带蒂空肠食管高位吻合手术治疗的可行性与疗效。方法:选取2012年2月-2013年4月本院收治的残胃食管癌患者107例。按照手术方法不同将其分为对照组37例和研究组70例。对照组应用结肠代食管术,研究组应用带蒂空肠食管高位吻合手术。比较两组手术时长、术中出血量、胃肠道恢复时间、首次进食时间、首次下床时间、住院时长、并发症情况,术后生存率以及生存质量评分(WHOQOL-BREF)。结果:研究组手术时长、胃肠道恢复时间、首次进食时间、首次下床时间、住院时长均短于对照组,术中出血量少于对照组,比较差异均有统计学意义(P<0.05);研究组并发症发生率为5.7%,低于对照组的29.7%(P<0.05);研究组术后1、3、5年生存率均高于对照组,但比较差异均无统计学意义(P>0.05);研究组WHOQOL-BREF各项评分均高于对照组,比较差异均有统计学意义(P<0.05)。结论:在残胃食管癌治疗过程中,带蒂空肠食管高位吻合手术治疗较为可行,临床价值较高。

Objective:To investigate the feasibility and efficacy of pedicled jejunal esophagus high anastomosisoperation for patients with remnant stomach esophagus cancer.Method:A total of 107 patients with remnant stomach esophagus cancer admitted to our hospital from February 2012 to April 2013 were selected.According to the method of operation,they were divided into 37 cases of control group and 70 cases of study group.The control group was treated with colon replacement of esophagus,and study group was treated with pedicled jejunal esophagus high anastomosisoperation.The operative time,intraoperative bleeding volume,gastrointestinal recovery time,first eating time,first getting out of bed time,length of stay,complications,survival rate after operation and quality of life score(WHOQOL-BREF) between two groups were compared.Result:The operative time,gastrointestinal recovery time,first eating time,first getting out of bed time,length of stay in study group were shorter than those of control group,the intraoperative bleeding volume was less than that of control group,the differences were statistically significant(P<0.05).The incidence of complications was 5.7% in study group,which was lower than 29.7% in control group(P<0.05).The survival rate of 1,3 and 5 years after operation in study group were higher than those of control group,but the differences were not statistically significant(P>0.05).The each score of WHOQOL-BREF in study group were higher than those of control group,the difference were statistically significant(P<0.05).Conclusion:In the treatment of remnant stomach esophagus cancer,pedicled jejunal esophagus high anastomosisoperation is feasible and of high clinical value.