经腹吻合口并胃底再造成形术在治疗贲门癌手术中的应用  

APPLICATION OF TRANSABDOMINAL ANASTOMOSIS COMBINED WITH GASTRIC FUNDUS RECONSTRUCTION IN THE TREATMENT OF CARDIAC CANCER

作　　者：陈涛[1] 张大伟[1] 马玲[1] 杜兰民[1] 王萍 CHEN Tao;ZHANG Da-wei;MA Ling;DU Lan-min;WANG Ping(Linyi Traditional Chinese Medicine Hospital,Linyi 276002,China)

机构地区：[1]临沂市中医医院,山东临沂276002 [2]临沂市肿瘤医院

出　　处：《山东医学高等专科学校学报》2019年第1期16-19,共4页Journal of Shandong Medical College

摘　　要：目的探讨降低贲门癌根治术后并发症的方法。方法将110例患者随机分为两组。对照组使用吻合器食管胃后壁端侧吻合;治疗组采用食管管状胃前壁端侧吻合后,再造胃底并吻合口内凸成形术,将吻合口部位重建成"Gubaroff"瓣样的贲门胃底结构。术后定期观察比较两组并发症的发生情况。结果治疗组在术后生活质量、反流性食管炎评分、胃排空功能、食管黏膜分级、反流液酸度等方面均优于对照组(P<0.05);两组手术时间、吻合口狭窄程度、吻合口瘘发生率比较无统计学意义(P>0.05)。结论经腹吻合口并胃底再造成形术,能有效降低术后并发症的发生,改善了患者生活质量。Objective To investigate the method of reducing the complications after radical resection of cardiac cancer. Methods 110 patients were randomly divided into two groups. The control group was treated with end-to-side anastomosis of the posterior esophagogastric wall with stapler;the treatment group was treated with end-to-side anastomosis of the anterior esophagogastric wall with esophageal tubular anastomosis, then the fundus of stomach was reconstructed, and the anastomotic site was reconstructed into a "Gubaroff" valve-like cardia-fundus structure, and then the complications of the two groups after operation were observed and compared regularly. Results The quality of life, reflux esophagitis score, gastric emptying function, grading of esophageal mucosa and acidity of reflux fluid in the treatment group were better than those in the control group ( P <0.05);there was no significant difference in operation time, degree of anastomotic stricture and incidence of anastomotic leakage between the two groups ( P >0.05). Conclusion Transabdominal anastomosis combined with fundus reconstruction can effectively reduce the incidence of postoperative complications and improve the life quality of patients.

关 键 词：贲门癌 吻合口成形术 胃底再造重建 

分 类 号：R735.2[医药卫生—肿瘤]