全胃切除食管空肠分层吻合58例临床应用体会

目的 观察食管空肠分层吻合术应用于全胃切除术后消化道重建的临床效果.方法 选取115例全胃切除术患者并随机分为对照组(57例)和观察组(58例).对照组采用传统的食管空肠全层吻合术、观察组采用食管空肠分层吻合术进行消化道重建.观察两组患者术后并发症发生情况.结果 115例患者均顺利完成手术,观察组1例(1.72％)发生反流性食管炎,X线钡餐检查显示,钡剂可顺利通过吻合口.对照组患者9例(15.79％)发生并发症,其中3例为吻合口瘘,6例为反流性食管炎.两组并发症发生率比较具有统计学意义(P ＜0.05).结论 空肠分层吻合术应用于全胃切除术后消化道重建,效果良好,可有效降低术后并发症的发生.

LAYERED ANASTOMOSIS IN ESOPHAGEAL JEJUNUM AFTER TOTAL GASTRECTOMY IN 58 CASES

Objective To observe the clinical effect of the layered anastomosis esophagus jejunum used for the reconstruction of digestive tract after total gastrectomy.Methods115 cases of total gastrectomy were randomly divided into the contrast group of 57 patients treated with whole-layer anastomosis for the digestive tract reconstruction and the observation group of 58 patients treated with layered anastomosis for digestive tract reconstruction.The incidence of postoperative complications were observed and compared between the two groups.ResultsAll patients got successful operations.In the observation group,one case suffered from reflux esophagitis,and the X-ray barium meal examination showed that the barium passed stoma successfully.In the contrast group,9 patients suffered from complications of 3 cases of anastomotic leakage and 6 cases of reflux esophagitis.There existed significant difference in the rate of complicationsbetween the two groups(P<0.05).ConclusionLayered anastomosis used after total gastrectomy can help to reconstruct digestive tract and effectively reduce the incidence of postoperative complications.