管状胃代食管吻合术与全胃手术治疗食管癌的近期疗效及安全性比较  

Comparison of the short-term curative effects and safety of tubular gastric replacement between the esophagus anastomosis and total gastric operation in the treatment of esophageal carcinoma

作　　者：于苗子[1] 刘朋涛[1] 许海伟[1] 

机构地区：[1]漯河医学高等专科学校第二附属医院外科,河南462300

出　　处：《中国临床新医学》2016年第12期1142-1144,共3页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的比较管状胃代食管吻合术与全胃手术治疗食管癌的近期疗效及安全性。方法选取该院2012-11-2014-11收治的食管癌患者76例,随机分为对照组和观察组,每组38例。对照组行全胃代食管吻合术治疗;观察组行管状胃代食管吻合术治疗。统计两组患者手术时间、术中出血量、淋巴结清扫数,观察两组患者术后吻合口瘘、胸胃综合征、肺部并发症、心血管并发症、胃排空障碍、胃食管反流等发生情况。结果两组患者均无围手术期死亡,观察组患者淋巴结清扫数[（15.6±3.4）个]显著多于对照组[（12.8±2.6）个]（P〈0.05）;对照组患者术后胸胃综合征、肺部并发症、心血管并发症、胃排空障碍、胃食管反流发生率分别为23.7%、36.8%、26.3%、28.9%、28.9%,观察组为5.3%、15.8%、7.9%、7.9%、10.5%,观察组并发症发生率低于对照组,两组比较差异有统计学意义（P〈0.05）。结论与全胃代食管吻合术比较,管状胃代食管吻合术治疗食管癌能更有效地清扫淋巴结,减少术后心、肺并发症发生,疗效确切,安全性良好。Objective To compare the short-term curative effects and safety between tubular gastric replacement of the esophagus anastomosis and total gastric operation in the treatment of esophageal carcinoma. Methods Seventy-six patients with esophageal carcinoma treated in our hospital from November 2012 to November 2014 were randomly divided into the control group（ n = 38） and the observation group（ n = 38）. The control group was treated with total gastric replacement of the esophagus anastomosis while the observation group was treated with tubular gastric replacement of the esophagus anastomosis. The operation time,intraoperative blood loss and the number of cleared lymph nodes were compared between the two groups. The incidences of the postoperative anastomotic leakage,thoracic stomach syndrome,pulmonary complications,cardiovascular complications,gastric emptying disorder and gastroesophageal reflux were observed in the two groups. Results There were no perioperatively dead cases in the two groups. The number of cleared lymph nodes in the observation group（ 15. 6 ± 3. 4） was significantly more than that in the control group（ 12. 8 ± 2. 6）（ P〈0. 05）; The incidences of thoracic stomach syndrome,pulmonary complications,cardiovascular complications,gastric emptying disorder and gastroesophageal reflux in the observation group（ 5. 3%,15. 8%,7. 9%,7. 9%,10. 5%） were significantly lower than those in the control group（ 23. 7%,36. 8%,26. 3%,28. 9%,28. 9%）（ P〈0. 05）. Conclusion Tubular gastric replacement of the esophagus anastomosis is safe and effective than total gastric replacement of the esophagus anastomosis in the treatment of esophageal carcinoma.

关 键 词：管状胃代食管吻合术 全胃代食管吻合术 食管癌 

分 类 号：R61[医药卫生—外科学]