食管胃端侧吻合加胃底折叠术预防胃上部癌术后并发症的临床观察  

Clinical study for preventing postoperative complication by esophag-stomach end-to-side anastomosis combine fundoplication with proximate gastric carcinoma

作　　者：杨正华[1] 凌峰[1] 张社芹[1] 王湘莲[2] 

机构地区：[1]湖南省永州职业技术学院附属医院普外科,湖南永州425006 [2]南华大学永州临床学院外四科,湖南永州425006

出　　处：《中国现代普通外科进展》2008年第3期213-215,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:观察食管胃端侧吻合加胃底折叠术预防胃上部癌术后并发症的效果。方法:选取42例胃上部癌作为治疗组,行胃端侧吻合加胃底折叠术,选取同期病况基本相同的38例病例作为对照组,行传统食管胃端端吻合术进行对比分析。术后4～6个月行胃镜检查,观察有无反流性食管炎、吻合口瘘、吻合口狭窄的发生。术后随访6个月,观察患者有无胃部烧灼感、反酸、胸部不适及吞咽困难等情况。结果:治疗组与对照组相比较,反流性食管炎的发生明显减少,差异具有统计学意义(P<0.05),而吻合口瘘、吻合口狭窄的发生率接近,差异无统计学意义(P>0.05)。结论:食管胃端侧吻合加胃底折叠术在胃上部癌治疗中能显著减少反流性食管炎的发生,值得推广。Objective： To evaluate the efficacy of esophag-stomach end-to-side anastomosis combine fundoplication for preventing the postoperative complication for proximate gastric carcinoma disease. Methods： Eighty proximate gastric carcinoma patients were randomly assigned into two groups, and 42 patients（treating group） were operated by esophag-stomach end-to-side anastomo-sis combine fundoplication,the other patients （control group） were operated by esophag-stomach end-to-end anastomosis,observe the appearance of reflux esophagitis,stoma fistulae and stoma stegnosis by gastroscopy after 4 to 6 months,and follow up the patients for 6 months,to observe the appearance of burning sensation,sour regurgitation, baenosome indisposition and acataposis. Results： To compare with control group, it was lower appearance of reflux esophagitis in treating group t （P〈0.05）,but it was no significance for the appearance of stoma fistulae and stoma stegnosis （P〉0.05）. Conclusion： could decrease the appearance of reflux esophagitis obviously by esophag-stomach end-to-side anastomosis combine fundopication for the therapy of proximal gastric carcinoma.

关 键 词：近端胃切除 食管胃吻合 胃底折叠术 术后并发症 胃肿瘤 

分 类 号：R656.61[医药卫生—外科学] R735.2[医药卫生—临床医学]