直线型缝合器重塑管状胃代食管对胸段食管癌的疗效及并发症观察  

Study on the efficacy and complications in application of linear stapler for remodeling tubular stomach in thoracic esophageal cancer surgery

作　　者：朱应超 刘公哲 尹波[1] 张磊[1] 李大宏[1] ZHU Ying-chao;LIU Gong-zhe;YIN Bo(Department of Cardiac Surgery,Laiwu City People＇s Hospital,Laiwu Shandong 271100,China)

机构地区：[1]莱芜市人民医院胸心外科,山东莱芜271100

出　　处：《临床和实验医学杂志》2018年第15期1654-1656,共3页Journal of Clinical and Experimental Medicine

基　　金：济宁医学院附属医院博士科研启动基金计划项目(编号:2017-BS-005)

摘　　要：目的探讨胸段食管癌切除手术中应用直线型缝合器重塑管状胃代食管重建消化道的的临床效果。方法采用回顾性分析,以2015年6月至2017年2月莱芜市人民医院93例胸段食管癌手术病例作为研究对象,按手术方式分为管状胃代食管组(48例)和传统全胃代食管组(45例)。分别对比两组手术时间、出血量、术后并发症及术后1个月患者的肺功能。结果两组患者均成功完成手术。两组术中手术时间及出血量差异无统计学意义(P>0.05)。管状胃代食管组术后1个月的最大通气量占预计值的百分比(MVV%)、肺活量占预计值的百分比(VC%)及第一秒用力呼气容积占预计值的百分比(FEV1%)均高于传统全胃代食管手术组,差异有统计学意义(P<0.05)。术后并发症如吻合口瘘、心律失常及吻合口狭窄的发生率比较,两组差异无统计学意义(P>0.05);管状胃代食管组术后并发肺部感染率(2.1%)低于传统全胃代食管组(24.4%),差异有统计学意义(P<0.05);传统全胃代食管组的术后并发胸胃综合征发生率(8.9%)高于管状胃代食管组(0);管状胃代食管组术后并发反流性食管炎发生率(6.3%)低于传统全胃代食管组发生率(26.7%),差异均有统计学意义(P<0.05)。结论采用直线型缝合器重塑管状胃代食管对胸段食管癌的疗效较好,并且可以降低患者术后并发胸胃综合征、反流性食管炎等的风险,具有很好的临床应用价值。Objective To explore the efficacy and complications in application of linear stapler for remodeling tubular stomach in thoracic esophageal cancer surgery. Methods The clinical data of 93 patients received thoracic esophageal cancer surgery in this hospital during June 2015 to February 2017 were retrospectively reviewed and studied. All these patients were divided into two groups according to surgical procedures,patients in group A（ n = 48） were performed with gastric tube esophagectomy; and patients in group B（ n = 45） underwent whole stomach reconstruction esophagectomy. The clinical indexes such as operating time,amount of intraoperative bleeding,incidence of postoperative complications and disorders in respiratory functions in these two groups were compared. Results All these patients had successfully completed radical operation.There was no significant difference in operating time and amount of intraoperative bleeding（ P〈0. 05）. Patients in group A had higher value of vital capacitty（ VC%）,MVV% and FEV1% than those of patients in group B,and the difference was statistically significant（ P〈0. 05）. There were less cases with pulmonary infection,thoracic stomach syndrome and reflux esophagitis in group A in comparison with those of patients in group B. Conclusion The clinical efficacy of linear stapler for remodeling tubular stomach in thoracic esophageal cancer surgery has good value for clinical application.

关 键 词：胸段食管癌 管状胃代食管 直线型缝合器 全胃代食管 

分 类 号：R735.1[医药卫生—肿瘤]