两种不同食管上提方式治疗食管癌的临床疗效比较  

Comparison of clinical effects of two different types of esophageal lifting in the treatment of esophageal cancer

作　　者：陈宏明[1] 李日著[1] 罗世官[1] 高洁[2] 谭荣邦[1] 

机构地区：[1]右江民族医学院附属医院,百色533000 [2]右江民族医学院病理生理学教研室,百色533000

出　　处：《右江医学》2016年第3期277-279,共3页Chinese Youjiang Medical Journal

基　　金：2014年广西百色市科学研究与技术开发计划项目(百科计20141106);广西高校桂西地区高发病防治研究重点实验室开放课题(gxzdsysyy2015208);右江民族医学院校级课题(右医科字〔2014〕2号)

摘　　要：目的：比较食管癌三切口手术中，管状胃经食管床和经胸骨后两种不同上提方式行胃食管颈部吻合的临床疗效。方法选取2010年6月~2015年6月间112例行食管癌三切口手术患者，随机分为 A 组和 B 组，每组56例，A 组和 B 组分别采用经食管床和经胸骨后路径行管状胃上提完成胃食管颈部吻合。结果 A 组手术时间、术中出血量及住院时间均少于 B 组，但比较差异无统计学意义（P〉0.05）；A 组术后胸腔引流量和胸管引流时间均多于 B组，比较差异有统计学意义（P〈0.001）；A 组并发症发生率为39.29%，B 组并发症发生率为21.43%，两组差异有统计学意义（P〈0.05），其中 A 组术后并发肺部感染、肺不张发生率高于 B 组，吻合口瘘发生率低于 B 组（P〈0.05）。结论经胸骨后和经食管床两种不同上提方式行胃食管颈部吻合均是安全、有效的路径，各有优缺点，在临床实际工作中，应该根据患者的具体情况选择不同管状胃上提方式。Objective To compare the clinical efficacy of cervical esophagogastrostomy by esophageal lifting through e-sophagus bed and trans-substernal approach after three-phase esophagectomy for esophageal carcinoma.Methods A total of 112 patients who underwent three-phase esophagectomy from June,2010 to June,2015 were enrolled in this study,and they were randomly divided into group A and group B,with 56 cases in each.Esophageal and cervical anastomosis of the group A and the group B was performed by esophageal lifting through esophagus bed and trans-substernal approach respectively.Re-sults Operation time,intraoperative blood loss and hospital stays of the Group A were less than those of the Group B,but there was no statistically significant difference（P〉0.05）.Postoperative thoracic drainage and thoracic drainage time of the Group A were more than those of the Group B,so difference was statistically significant（P〈0.001）.Incidence of complications of the Group A was 39.29%,and that of the Group B was 21.43%,so difference was statistically significant（P〈0.05）.Inci-dence of pulmonary infection and and pulmonary atelectasis after operation in the Group A were higher than those of the Group B,while incidence of anastomotic leaka was lower than that of the Group B（P〈0.05）.Conclusion Cervical esopha-gogastrostomy by esophageal lifting through both esophagus bed and trans-substernal approach are safe and effective,each way has advantages and disadvantages.Thus,different ways should be selected according to specific conditions of the patients in clinical practice.

关 键 词：食管癌 管状胃 经食管床 经胸骨后 

分 类 号：R735.1[医药卫生—肿瘤]