纵隔胸膜在中上段食管癌中的应用  

Functions of Stay Suture of Mediastinal Pleura Overlying Esophagus in Esophagectomy for Patients with Upper or Middle Esophageal Carcinoma

作　　者：张荣新[1] 彭康宁[1] 朱金海[1] 

机构地区：[1]安徽省蚌埠医学院第一附属医院肿瘤外一科,233004

出　　处：《中华全科医学》2012年第4期511-511,572,共2页Chinese Journal of General Practice

摘　　要：目的探讨纵隔胸膜在中上段食管癌中应用的意义。方法选择肿瘤外科手术切除中上段食管癌482例,分为A、B两组。A组230例:2006年8月以前未缝合纵隔胸膜组;B组252例:2006年8月以后缝合组。两组患者肿瘤均位于食管中上段,其临床病理分期如下:Ⅰ期107例,Ⅱa期148例,Ⅱb期143例,Ⅲ期84例。结果所有患者均手术顺利,无近期死亡。吻合口瘘A组13例,B组4例;胸闷不适A组37例,B组13例。两组比较差异有统计学意义(P<0.05),改善了患者术后生存质量。严重的反流性食管炎、肺部感染、肺不张、切口感染等并发症在本研究组中差异无统计学意义(P>0.05)。结论在中上段食管癌,采用纵隔胸膜覆盖,明显减少吻合口瘘和胸闷不适的发生;而且操作简单,易于推广。objective To explore the application of mediastinal pleura in the esophagectomy for the patients with upper or middle esophageal carcinoma. Methods Four hundred and eighty two patients with upper or middle esophageal carcinoma were divided into 2 groups. Group A（230 cases, before Aug. 2006） ：the mediastinal pleura were unstitched;Group B （252 cases, after Aug. 2006） ： the mediastinal pleura were unstitched. The carcinomas were all upper or middle esophageal carcinoma in both groups. The TNM stages were 107 of Stage I , 148 of Stage II a, 143 of Stage I1 b and 84 of Stage m. Results All patients had satisfactory operation processes, without perioperative death. In group A, 13 cases were with anastomotic fistula, 37 cases with chest distress; while in group B ,4 cases with anastomotic fistula, 13 cases with chest distress, and there was statistically difference （P 〈 0.05） between the two groups. The life quality of the patients was improved. The rate of complications such as severe gas troesophageal reflux, pulmonary infection and atelectasis were not statistically difference（ P 〉 0.05 ） between the two groups. Con clusion The radical operation with remaining integrated mediastimal pleura in patients with upper or middle esophageal carcino ma can reduce the incidence of anastomotic fistula and chest distress, and easy to be used in clinical practice.

关 键 词：纵隔胸膜 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]