切除胃小弯的管状胃加颈吻合治疗胸段食管癌前瞻性研究  

A clinical study of the lesser curvature-cut gastric tube reconstruction after esophagectomy for esophageal carcinoma

作　　者：傅俊惠[1] 黄建豪[1] 吴智勇[1] 郑海波[1] 郑春鹏[1] 朱映辉[1] 王卫光[1] 陈书裕[1] 

机构地区：[1]汕头市中心医院肿瘤外科,广东省汕头515031

出　　处：《中国基层医药》2008年第1期18-19,共2页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省卫生厅医学科学研究基金资助项目（A2006637）

摘　　要：目的探讨切除胃小弯的管状胃在食管癌切除食管重建术中的临床应用及其对术后生活质量的影响。方法将316例胸段食管癌随机分为治疗组及对照组：治疗组切除胃小弯侧形成管状胃，从食管裂孔经后纵隔食管床主动脉弓后方原位移至胸膜顶或左颈部行食管断端胃吻合术，食管-管状胃吻合采用延长食管及胃黏膜的套叠式吻合，共162例；对照组用全胃在胸膜顶或左颈部行食管断端胃全层吻合术，共154例。结果术后均顺利康复出院。治疗组与对照组相比较，其吻合口瘘、吻合口狭窄、胸胃综合征及反流性食管炎等并发症发生率明显减少。结论该术式重建消化道后更符合生理解剖的要求，减少术后近、远期并发症的发生，改善术后生活质量。Objective To evaluate the application of gastric tube reconstruction,and the effect on the quality of life after esophageal resection. Methods After lesser curvature was cut, the gastric tube was reconstructed in the neck or at the cupula of pleura via the retromediastinal route through esophageal hiatus. Results All 162 patients were recovered after operation. The incidences of anastomotic stenosis, thoracogastric syndrome and reflux esophagitis were decreased. Conclusion The procedure of gastric tube reconstruction fits physiologicoanatomical function of the digestive tract. It could reduce the early and long-term complications and improve the postoperative quality of life.

关 键 词：食管肿瘤 胃切除术 食管切除术 胸胃综合征 

分 类 号：R735.1[医药卫生—肿瘤] R735.205[医药卫生—临床医学]