半包埋活瓣式吻合应用于食管胃结合部癌防反流的疗效分析

Effect of semi-embedded valve anastomosis on anti-reflux after proximal gastrectomy for esophagogastric junction cancer

目的采用半包埋活瓣式吻合手术方式预防食管胃结合部癌患者术后出现的反流症状,并评价此种手术方式预防反流的效果。方法回顾性分析2018年1月至2019年4月于河北医科大学第二医院胃肠外科15例患者因食管胃结合部癌行近端胃手术切除治疗,并采用半包埋活瓣式吻合方式进行吻合的临床资料,采用反流性疾病问卷量表评分比较患者术前与术后反流的差异。结果15例患者术后均恢复良好,有2例患者术后1个月内出现吞咽不畅,在胃镜下扩张吻合口1次后症状消失。15例患者手术前后反流性疾病问卷表评分相比差异无统计学意义(16±12比10±4,t=1.877,P=0.081)。结论半包埋活瓣式吻合手术方式对食管胃结合部癌患者术后有一定的防反流效果。

Objective To prevent postoperative reflux symptoms in patients undergoing proximal gastrectomy for esophagogastric junction cancer by using a new method of anti-reflux anastomosis.Methods The clinical data of 15 patients with esophagogastric junction cancer at Department of Gastrointestinal Surgery,Second Hospital of Hebei Medical University from Jan 2018 to Apr 2019 were analyzed,and a new method of anti-reflux anastomosis was used to compare the difference of reflux between preoperative and postoperative status.Results All patients recovered well after operation,2 patients suffered moderate swallow disturbance after one month of operation,and the symptoms disappeared by gastroscope anastomosis dilation.The scores of reflux disease questionnaire before and after operation were in accordance with normal distribution(16±12 vs.10±4,t=1.877,P=0.081),the results showed that there was no significant difference.Conclusion This new method of anti-reflux anastomosis has a definite anti-reflux effect on postoperative patients with esophagogastric junction cancer.