细管状胃联合幽门成形在食管癌手术治疗的临床研究  

Clinical study on thin tubular stomach combined with pyloroplasty in surgical treatment of esophageal cancer

作　　者：陆佳昊 魏长江[1] 田敬林 LU Jiahao;WEI Changjiang;TIAN Jinglin(Department of Thoracic Surgery,Suzhou Kowloon Hospital Affiliated to Shanghai Jiao Tong University,Suzhou 215000,China;Department of Pharmacy,Suzhou Kowloon Hospital Affiliated to Shanghai Jiao Tong University,Suzhou 215000,China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院胸外科,江苏苏州215000 [2]上海交通大学医学院附属苏州九龙医院药学部,江苏苏州215000

出　　处：《中国医药科学》2019年第20期25-28,共4页China Medicine And Pharmacy

摘　　要：目的分析食管癌术中使用细管状胃替代食管同时联合幽门成形的效果。方法2011年10月~2017年12月我院胸外科收治的58例食管癌中老年患者资料。根据手术时间、术中出血量、清扫淋巴结数量、切缘癌残留、住院时间、术后肺功能以及术后相关并发症,从而评估该手术方式的临床意义。结果58例食管癌(1)手术时间(227.30±11.45)min,术中出血量(181.24±24.23)mL,淋巴结清扫数(13.53±0.68)枚,住院时间(11.50±1.4)d。(2)术后出现1例吻合口瘘、1例吻合口狭窄、2例肺部感染、3例手术切口感染,无管胃瘘、喉返神经损伤、切缘癌残留、胸胃综合征、乳糜胸、心血管并发症、胃排空障碍、反流性食管炎等并发症发生。(3)术后1个月VC(2.85±0.78)L,FEV1(1.72±0.16)L,MVV(68.52±6.18)L/min,与术前相比无明显下降(P>0.05)。结论食管癌切除后使用细管状胃替代,并且联合幽门成形,手术安全,术后患者并发症少,恢复良好,生活质量肯定。Objective To analyze the curative effects of thin tubular stomach instead of the esophagus combined with pyloroplasty in surgical treatment of esophageal cancer.Methods Clinical data of 58 middleaged and elderly patients with esophageal cancer who were admitted and treated in our hospital from October 2011 to December 2017 were collected.The clinical significance of this surgical method was evaluated according to operation time,intraoperative blood loss,number of dissected lymph nodes,the residual tumor after resection,hospital stay,postoperative lung function and postoperative complications.Results(1)In 58 patients with esophageal cancer,operation time was(227.30±11.45)min,intraoperative blood loss was(181.24±24.23)mL,number of dissected lymph nodes was(13.53±0.68)and hospital stay was(11.50±1.4)days.(2)After surgery,there was 1 case of anastomotic leakage,1 case of anastomotic stenosis,2 cases of pulmonary infection and 3 cases of surgical wound infection.There was no occurrence of complications such as tubular gastric fistula,recurrent laryngeal nerve injury,the residual tumor after resection,thoracic-gastro syndrome,chylothorax,cardiovascular complications,delayed gastric emptying and reflux esophagitis.(3)On one month after surgery,VC was(2.85±0.78)L,FEV1 was(1.72±0.16)L and MVV was(68.52±6.18)L/min.There was no significant decrease compared with preoperative indexes(P>0.05).Conclusion After resection of esophageal cancer,thin tubular stomach instead of the esophagus combined with pyloroplasty is safe.The postoperative complications are few,the recovery is good and the quality of life is positive.

关 键 词：食管肿瘤 管状胃 食管切除 幽门成形 

分 类 号：R735[医药卫生—肿瘤]