管状胃-食管吻合术联合胸腔镜食管癌切除术在老年食管癌治疗中的应用

Application of Tubular Gastroesophageal Anastomosis combined with Thoracoscopic Esophageal Cancer Resection in Elderly Patients with Esophageal Cancer

目的研究管状胃-食管吻合术联合胸腔镜食管癌切除术在老年食管癌治疗中的应用。方法85例老年食管癌患者随机分为对照组(42例)和观察组(43例)。2组患者均行胸腔镜食管癌切除术治疗,对照组患者在食管癌切除术后行传统全胃代食管吻合术重建消化道,观察组患者在食管癌切除术后行管状胃-食管吻合术重建消化道。对比2组患者胃功能指标、呼吸功能指标、胃食管反流发生情况和并发症发生情况。结果治疗后,观察组患者的蠕动频率、蠕动收缩压、胸胃静息压显著高于对照组(P<0.05)。观察组患者的VC%、MVV%、FEV1%显著高于对照组(P<0.05)。观察组患者pH值<4总时间、最长酸反流时间、24 h反流次数均显著低于对照组(P<0.05),观察组术后3个月内的GerdQ评分降低明显(P<0.05)。结论相比传统全胃代食管吻合术,管状胃-食管吻合术联合胸腔镜食管癌切除术治疗老年食管癌优势明显。

Objective To study the application of tubular gastroesophageal anastomosis combined with thoracoscopic esophageal cancer resection in elderly patients with esophageal cancer.Methods Eighty-five elderly patients with esophageal cancer were randomly divided into the control group(42 cases)and the observation group(43 cases).Patients of both groups underwent thoracoscopic esophageal cancer resection,patients in the control group underwent conventional gastroesophageal anastomosis after esophageal cancer resection to reconstruct the digestive tract,while patients in the observation group underwent tubular gastroesophageal anastomosis after esophageal cancer resection to reconstruct the digestive tract.The gastric function index,respiratory function index,gastroesophageal reflux and complications were compared between the two groups.Results After treatment,the peristaltic frequency,peristaltic systolic blood pressure,and chest-gastric rest pressure of the observation group were significantly higher than those of the control group(P<0.05).The VC%,MVV%and FEV1%of the observation group were significantly higher than those of the control group(P<0.05).The total time of pH<4,the longest acid reflux time,and the number of 24h reflux were significantly lower than that of the control group(P<0.05).The GerdQ score of the observation group decreased significantly within 3 months after operation(P<0.05).Conclusion Compared with traditional gastroesophageal anastomosis,tubular gastroesophageal anastomosis combined with thoracoscopic esophageal cancer resection for elderly patients with esophageal cancer has obvious advantages.