管状胃在胸腹腔镜联合食管癌根治术中的应用探讨  

Application of gastric tube in combined thoracoscopic-laparoscopic esophagectomy for treatment of esophageal carcinoma

作　　者：饶新辉[1] 梁锦崧[1] 张自正[1] 陈刚[1] RAO Xinhui LIANG Jinsong ZHANG Zizheng CHEN Gang(Meizhou People＇s Hospital, Meizhou , Guangdong 514031, China.)

机构地区：[1]梅州市人民医院胸外科,广东梅州514031

出　　处：《岭南现代临床外科》2017年第1期72-76,共5页Lingnan Modern Clinics in Surgery

基　　金：广东省梅州科技立项(2012B07)

摘　　要：目的探讨管状胃在胸腹腔镜联合食管癌根治术中的临床应用价值。方法选取2011年1月至2015年12月在我院行胸腹腔镜联合食管癌根治术治疗的胸段食管癌患者160例,将其分为两组,分别采用管状胃代食管手术和传统全胃缝缩术治疗。记录两组患者手术完成情况、比较两组患者淋巴结清扫个数、失血量、手术时间、胸管留置时间、术后引流量、围手术期和随访期间并发症发生率、记录并发症处理情况、比较两种手术方法的总体疗效。结果两种术式在胸部淋巴结清扫个数、术中失血量、胸管留置时间和术后引流量方面无明显差异(P>0.05);管状胃代食管术手术时间、腹部淋巴结清扫个数明显多于全胃缝缩术(P<0.05)。管状胃代食管术的并发症发生率明显低于全胃缝缩术(P<0.05)。管状胃代食管术住院时间、术后进食时间、复发和转移率、2年生存率和生活质量均明显优于全胃缝缩术(P<0.05)。两组1年生存率无明显差异(P>0.05)。结论管状胃代食管术可有效减少食管癌术后并发症,提高患者生活质量和生存率,安全可靠。Objective To compare the results of combined thoracoscopic-laparoscopic andopen esophagectomy performed for esophageal squamous cell carcinoma. Methods 160 patients withthoracic esophageal carcinoma from January 2011 and December 2015 in our hospital for treatment ofradical resection of thoracic esophageal carcinoma combined with laparoscopy were divided into twogroups,respectively,using the tubular gastric reflux surgery and traditional gastric closure treatment.Records of two patients completed surgery,compared two groups of patients with lymph node dissectionnumber, operation time, blood loss, chest tube indwelling time, postoperative drainage,perioperative complications,and follow- up records of complications,comparison of two operativemethods for total efficacy. Results Two kinds of operation in the thoracic lymph node dissection,intraoperative blood loss volume,the number of the chest tube drainage time and postoperative drainagehad no significant difference（P〈0.05）;gastric tube interposition surgery time,abdominal lymph nodedissection significantly more than the number of total gastric closure（P〈0.05）. The incidence rate ofcomplications of tubular stomach replacement of esophagus was significantly lower than that of wholegastric suture（P〈0.05）. The time of hospitalization,postoperative feeding time,recurrence andmetastasis rate,two-year survival rate and quality of life（QOL）were significantly higher than that ofwhole gastric suture（P〈0.05）. There was no significant difference in survival rate between the twogroups（P〈0.05）. Conclusion The treatment of esophageal cancer with esophageal tube can effectivelyreduce postoperative complications,improve the quality of life and survival rate of patients withesophageal cancer,and is safe and reliable.

关 键 词：管状胃 胸腹腔镜 食管癌 应用价值 

分 类 号：R655.4[医药卫生—外科学]