论文部分内容阅读
目的:探讨管状胃代替食管在食管癌根治术中的应用。方法:自2008年7月～2009年12月,87例胸中下段食管癌患者接受食管切除术,其中管状胃组41例行管状胃代食管吻合术,对照组46例采用传统胃代食管。分别比较2组手术时间、淋巴结清扫情况、出血量及术后并发症发生率。结果:87例均获成功,无手术死亡,两组手术时间相仿(145±38、136±45min),差异无显著性(P>0.05),对贲门旁及胃左动脉旁淋巴结清扫管状胃组较对照组更彻底(22.3±6.1、14.7±4.2枚),差异有显著性(P<0.05),术后随访80例,随访时间1个月～1年,胸胃综合征发生率管状胃组明显少于对照组(0%、10.9%),差异有显著性(P<0.05),反流性食管炎发生率管状胃组优于对照组(2.4%、8.7%),但尚无统计学差异(P>0.05)。结论:管状胃代食管相比传统胃代食管手术操作简单易行,安全性高,对腹腔淋巴结清扫更彻底,对患者术后生活质量影响小。
Objective: To explore the application of tubular stomach instead of esophagus in esophagectomy. Methods: From July 2008 to December 2009, 87 patients with esophageal carcinoma of lower and middle lower thoracic esophagus underwent esophagectomy. Among them, 41 patients underwent tubular stomach-assisted esophageal anastomosis in the tubular stomach group and 46 patients in the control group received traditional gastric esophageal esophagus. The operative time, lymph node dissection, blood loss and postoperative complications were compared between the two groups. Results: All of the 87 cases were successfully operated without any surgical death. The operation time of the two groups was similar (145 ± 38,136 ± 45min), with no significant difference (P> 0.05) The control group was more complete (22.3 ± 6.1,14.7 ± 4.2), the difference was significant (P <0.05), followed up 80 cases, follow-up time of 1 month to 1 year, the incidence of thoraco- (0%, 10.9%), the difference was significant (P <0.05), the incidence of reflux esophagitis in the tubular group was better than that in the control group (2.4%, 8.7%), but there was no statistical difference (P> 0.05). Conclusion: Compared with traditional gastric esophageal esophageal surgery, tubular gastric esophagus has the advantages of simple and safe operation, more thorough lymphadenectomy, and less impact on the postoperative quality of life.