胸腹腔镜联合中上段食道癌根治手术不同路径消化道重建对肺功能的影响  

Effect on Pulmonary Function after Different Approaches for Gastric Tube Reconstruction in Esophagectomy Combined with Thoracoscopy and Laparoscopy for Esophageal Carcinoma of Upper and Middle Segment

作　　者：周国华[1] 姚维深[1] 谢敬廉 罗学平[1] 洪强[1] ZHOU Guo -hua etal(Department of Cardiothoracic surgery, Nanhai People＇s Hospital, the Nanfang Medical University Affiliated Nanhai Hospital, Foshan 528200, Chin)

机构地区：[1]佛山市南海区人民医院/南方医科大学附属南海医院胸外科,广东佛山528200

出　　处：《牡丹江医学院学报》2017年第4期33-35,共3页Journal of Mudanjiang Medical University

基　　金：佛山市医学类科技攻关项目(2015085)

摘　　要：目的探讨胸腹腔镜联合中上段食道癌根治手术中管状胃经胸骨后与食管床不同上提路径对患者术后肺功能的影响。方法分析2014年12月至2016年2月在我院胸外科行胸腹腔镜中上段食管癌切除、食管胃颈部吻合术45例患者的围手术期临床资料,其中采用胸骨后路径者22例,食管床路径者23例,分析两组病例术后外周血气分析指标及肺功能指标。结果经胸骨后路径组术后3天的外周血气值以及术后7天的肺功能指标优于食管床组(P<0.05)。经胸骨后与食管床路径术后吻合口瘘(27.3%vs.17.4%)、肺部感染(13.6%vs.21.4%)发生率的差异无统计学意义(P>0.05)。结论经胸骨后与食管床行食管胃颈部吻合均是可行的消化道重建方式,应综合病人的因素进行个体化选择。Objective To explore the effect on pulmonary function after different approaches for gastric Tube Reconstruction in Esophagectomy Combined with Thoracoscopy and Laparoscopy for Esophageal carcinoma of upper and middle Segment. Methods A total of 45 patients underwent esophagectomy combined with thoracoscopy and laparoscopy for esophageal carcinoma of upper and mid- dle segment from December 2014 to February 2010 were selected. There were 22 patients in prevertebral group and 23 in retrosternal group. Index of blood gas analysis and lung function after operation with two groups were analyzed. Results Index of blood gas analysis on the 3th day and lung function on the 7th day after operation was better in retrosternal group than that in prevertebral group（ P 〈 0. 05 ）. There were no significant differences between the retrosternal group （ n = 22） and the pre - vertebral group （ n = 23 ） with regard to anastomotic leak （27.3% vs. 17.4% ） and pneumonia （ 13.6% vs. 21.4% ）. Conclusion Retrosternal and prevertebral routes for gastric tube reconstruction are both acceptable methods in esophagectomy. Individualized gastric tube reconstruction should be con- sidered.

关 键 词：食管肿瘤 胸腔镜 腹腔镜 食管切除术 肺功能 管状胃 

分 类 号：R735.1[医药卫生—肿瘤]