胃及吻合口行纵隔胸膜固定手术在食管癌治疗中的应用效果  

Gastro-anastomotic Mediastinal Pleura Fixation for the Treatment of Esophageal Cancer Patients

作　　者：庄敏[1] 史建国[1] 杨纯杰[1] ZHUANG Min Sill Jian-guo YANG Chun-jie(Department of Thoracic Surgery, Liyang People ~s Hospital, Liyang213300 , Jiangsu, China)

机构地区：[1]江苏省溧阳市人民医院胸外科,溧阳213300

出　　处：《中国现代手术学杂志》2016年第5期339-341,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨胃及吻合口行纵隔胸膜固定手术与常规方法在食管癌治疗中的应用效果及安全性。方法将本院收治的126例食管癌患者随机分为固定手术组及常规手术组,两组患者均给予食管癌根治术,固定手术组在食管癌根治术中行胃及吻合口行纵隔胸膜固定,比较两组患者术中出血量、手术时间、清扫淋巴结数等手术指标,吻合口瘘、肺部感染、胃排空延迟等并发症发生率,生存质量评分及生存率等远期指标。结果固定手术组手术时间显著高于常规手术组(P<0.05),术中出血量、清扫淋巴结数无显著差异(P>0.05);固定手术组吻合口瘘发生率显著低于常规手术组(P<0.05),肺部感染、胃排空延迟等并发症发生率无显著差异(P>0.05);固定手术组生存质量评分显著高于常规手术组(P<0.05),两组患者生存率无显著差异(P>0.05)。结论在常规食管癌根治术基础上,加行纵隔胸膜固定能够降低吻合口瘘发生率,提高患者的生活质量,值得临床推广应用。Objective To investigate the clinical efficacy and safety of the gastro-anastomotic mediastinal pleura fixation in the treatment of esophageal cancer patients. Methods 126 cases of esophageal cancer in our hospital were randomly divided into the gastropexy group and the conventional surgery group with 63 cases for each. All patients were given esophageal resection,while the gastropexy group had the gastroesophageal anastomosis fixed on the mediastinal pleura in addition. It was compared between the two groups in surgical indicators such as blood loss,operative time,and number of lymph node dissection,incidence of complications such as the anastomotic fistula,pulmonary infection,delayed gastric emptying,and long-term indicators such as quality of life and survival rates. Results The operative time of the gastropexy group was significantly longer than the conventional surgery group（ P 〈 0. 05）. And there was no significant difference of the blood loss and the number of lymph node dissection（ P 〉 0. 05）. The incidence of anastomotic leakage in the gastropexy group was significantly lower than the conventional surgery group（ P 〉 0. 05）. But there was no significant difference in the other complications such as lung infection,delayed gastric emptying,etc（ P 〉 0. 05）. The QOL score of the gastropexy group was significantly higher than the conventional surgery group（ P 〈 0. 05）,but the survival of the two groups had no significant difference（ P 〉 0. 05）. Conclusion Based on the conventional esophageal resection,gastro-anastomotic mediastinal pleura fixation can reduce the incidence of anastomotic leakage and improve the quality of life for esophageal cancer patients,which is worthy of clinical application.

关 键 词：食管肿瘤 吻合口瘘 纵隔胸膜固定 

分 类 号：R735.1[医药卫生—肿瘤]