食管癌切除机械吻合术后重建食管的测压和pH分析

MANOMETRIC DETERMINATION AND 24-HOUR pH MONITORING IN THE ESOPHAGUS AND INTRATHORACIC STOMACH AFTER PARTIAL ESOPHAGECTOMY WITH STAPLE ANASTOMOSIS FOR CARCINOMA

为探讨食管癌切除食管胃机械吻合术后重建食管与胃食管反流之间的关系 ,对 45例术后患者进行了食管胃的压力测定 ,其中 2 0例还进行了 2 4h食管pH监测、内镜检查及病理学检查。测压显示食管胃吻合口上方的压力高于吻合口下方 ,2 4h食管 pH监测结果有胃食管反流的存在 ,内镜和病理检查示 80 %患者有异常现象及食管炎征象。结果提示 ,食管癌切除食管胃吻合术后存在胃食管反流 ;反流的发生与术后时间的长短无关 ;半卧位睡眠是预防反流的有效方法 ;2

To investigate the relationship between partial esophagectomy with staple anastomosis for carcinoma and gastroesophageal reflux (GER). The pressure in the esophagus and intrathoracic stomach was measured with SG-Ⅱ computer manometer in 45 patients. Twenty-four-hour esophageal pH monitoring, endoscopy and pathological examination were performed in 20 patients. Resting pressure above the esophago-gastric anastomosis was higher than that under the esophago-gastric anastomosis. Twenty-four-hour pH monitoring revealed that GER occurred. Abnormal findings were observed in 80% of patients by endoscopic and pathological examinations. The results showed that GER existed in the patients after esophagectomy and esophagogastrostomy for esophageal cancer. The occurrence of GER with stapling anastomosis were similar to that with manual anastomosis. The occurrence of GER was not related with the length of postoperative period. Sleeping in semirecumbent position was an effective method to prevent GER for postoperative patients. Twenty-four-hour pH monitoring was a reliable method for detecting GER.