管状胃代食管在老年食管癌手术中的应用  

Clinical application of tubular stomach for esophageal resection in elderly patients

作　　者：李小丛[1] 朱宏[1] 孙薇[1] 扬威[1] 李金学[1] 程晓兰[1] 

机构地区：[1]四川省绵阳市中心医院心胸外科,621000

出　　处：《临床外科杂志》2013年第6期447-449,共3页Journal of Clinical Surgery

摘　　要：目的 评价管状胃和全胃代食管在老年食管癌患者（年龄大于60岁）手术中的应用效果.方法 选取2008年5月至2012年5月我院收治的127例60岁以上食管癌患者,按手术方式不同随机分为全胃代食管手术组（全胃组）和管状胃代食管手术组（管状胃组）.全胃组63例,管状胃组64例,观察两组患者术中出血、手术时间、术后乳糜胸、术后喉返神经麻痹、吻合口瘘、吻合口狭窄、心律失常、胸胃综合征、返流性食管炎、肺部并发症及住院时间等临床指标.结果 两组患者均顺利完成根治手术,无探查手术,无围手术期死亡.在术中出血、手术时间、术后乳糜胸、术后喉返神经麻痹、吻合口瘘和吻合口狭窄发生率比较,差异均无统计学意义,而两组心律失常、胸胃综合征发生率、返流性食管炎发生率、肺部并发症发生率、术后住院时间等指标比较,差异均有统计学意义.结论 管状胃在老年食管癌手术中,可以降低部分并发症发生率,可缩短住院时间和改善患者的生活质量,收到较好的临床效果.Objective To evaluate the clinical effects of using tubular stomach and whole stom-ach for esophageal resection in elderly patients （age 〉 60 yeas）. Methods Based on the surgical proce-dure, 127 elderly patients with esophageal cancer were randomized into the whole stomach group and the tubular stomach group. In the whole stomach group, there were 63 patients including 42 males and 31 fe-males, with an average age of 67.38 ± 4.62 years. The tubular stomach group had 64 patients, including 45 males and 29 females, with an average age of 65.26 ± 4.59 years. The intraoperative bleeding, operation duration, rate of chylothorax, recurrent laryngeal nerve paralysis, anastomotic leakage and stricture, thorac- ic-stomach syndrome, arrhythmia, reflux esophagitis, lung complication and hospital stay were observed. Results All operations were performed successfully without perioperative death and second exploration. There were no statistically significant differences in hemorrhage, operation duration, chylothorax, recurrent laryngeal nerve paralysis, or anastomotic leakage and stricture between the groups, but there was significant difference in arrhythmia, thoracic-stomach syndrome, reflux esophagitis, lung infection and hospital stay. Conclusion Tubular stomach for esophageal resection in elderly patients has a good value in clinical ap-plication with fewer complications, shorter hospital stay and better life quality.

关 键 词：老年 食管癌 管状胃 

分 类 号：R730[医药卫生—肿瘤]