管状胃代食管术在食管癌、贲门癌中的临床应用研究  

Applied value of gastric tube in surgery for esophageal and cardial carcinoma

作　　者：王宗林[1] 谢晓阳[1] 易军[1] 李晓亮[1] 

机构地区：[1]四川省内江市第一人民医院胸心外科,641000

出　　处：《临床外科杂志》2011年第8期550-552,共3页Journal of Clinical Surgery

摘　　要：目的探讨管状胃在食管癌、贲门癌切除术中的临床应用及对术后生活质量的影响。方法78例食管癌、贲门癌患者，随机分为常规手术组和管状胃组。常规组37例，男31例，女6例，年龄（62．70±5．89）岁，胸中段食管癌21例，胸下段食管癌14例，贲门癌2例。管状胃组41例，男33例，女8例，年龄（60．56±6．75）岁，胸中段食管癌20例，胸下段食管癌18例，贲门癌3例。观察两组患者手术时间、术中出血、输血，术后心律失常，肺部并发症，吻合口瘘，吻合口狭窄，返流性食管炎，胸胃综合征发生率及住院时间等临床指标。结果丽组患者均顺利完成手术，无围手术期死亡，两组心律失常（40．54％比19．51％，P=0．042）、肺部并发症（32．43％比12．20％，P=0．031）、返流性食管炎（27．02％比4．87％，P=0．007）、胸胃综合征发生率（16．22％比0，P=0．024）及术后住院时间[（12．16±1．99）d比（10．87±1．41）d，P=0．001）]等指标比较差异有统计学意义。而在手术时间，术中出血、输血，吻合口瘘及吻合口狭窄发生率比较差异无统计学意义。结论管状胃在食管癌、贲门癌手术中并发症发生率较低，不增加手术时间、可缩短住院时间，可改善患者的生活质量，具有较好的临床应用价值。Objective To evaluate the clinical outcome of gastric tube in radical surgery to treat esophageal and cardial carcinoma. Methods Based on the surgical procedure ,78 patients with esophageal or cardial carcinomas were randomized into the gastric tube group and the traditional way group. In the traditional way group,there were 37 patients including 31 males and 6 females, whose age averaged 62.70 ± 5.89 years. In these patients ,35 had esophageal carcinoma with 21 in the middle esophagus, 14 in the lower esophagus; And 2 patients had cardial carcinoma. The gastric tube group had 41 patients, including 33 males and 8 females, whose age averaged 60.56± 6.75 years. Among them, 38 patients had esophageal carcinoma with 20 in the middle esophagus and 18 in the lower esophagus, and 3 patients had cardial car- cinoma. All cases were treated with anastomosis in the thoracic cavity. The operation duration, the rate of anastomotic leakage and stricture, the heart and lung complication, the reflux esophagitis, the thoracic - stomach syndrome and the postoperative length of stay were observed. Results All operations were performed successfully without perioperative deaths. There was significant difference in arrhythmia （40.54% vs. 19.51%, P = 0. 042 ） , lung infection （ 32.43 % vs. 12.20%, P = 0.031 ）, reflux esophagitis （ 27.02% vs. 4.87 % , P = 0.007 ）, thoracic - stomach syndrome （ 16.22% vs. 0, P = 0. 024 ） and postoperative length of stay（ 12.16± 1.99 days vs. 10.87 ＋ 1.41 days, P = 0. 001 ）, but there was no statistically significant difference in the operation duration（ 187.24 ± 54.81 min vs. 180.71 ± 23.52 min, P = 0. 488 ）, hemorrhage（361.08 ± 141.53 mL vs. 386.83 ± 175.59 mL, P = 0. 481 ）, transfusion （72.97 ± 119.37 mL vs. 60.97 ±106.95 mL, P = 0. 641 ） , anastomotic leakage （ 8.11% vs. 0, P = 0. 204 ）, and anastomotic stricture（2.70% vs. 7.32% ,P =0. 683）between the traditional way group and the gastric tube group. Conclusion Gastric tube has a good value in clinic

关 键 词：食管癌 贲门癌 管状胃 

分 类 号：R730[医药卫生—肿瘤]