食管癌切除管状胃与全胃食管吻合对心肺功能的影响

目的探讨食管癌切除管状胃与全胃食管吻合对心肺功能的影响。方法自2008年9月至2009年12月,310例胸中下段食管癌患者接受食管切除术,其中管状胃组155例行管状胃代食管吻合术,全胃组155例采用传统全胃代食管吻合。分别于术前1周、术后第3个月、术后第6个月检查肺功能及心功能。用改良EORTC QLQ C-30法行食管术后6个月的生命质量测评。结果 310例患者均获成功,无手术死亡病例。术前1周肺功能及心功能比较差异无统计学意义(P>0.05);术后第3个月和第6个月管状胃组肺功能及心功能改善比全胃组明显,差异有统计学意义(P<0.05)。术后第6个月管状胃组在身体功能和情感功能好于全胃组,反流症状低于全胃组。结论管状胃代食管吻合术相比传统全胃代食管吻合术对食管癌患者术后呼吸功能及心功能影响较小,且生命质量高于传统全胃代食管吻合术。

Effect of the gastric tube in stead of esophagus on respiratory and cardiac function after esophagectomy

Objective To evaluate the application and the effect of gastric reconstruction with tubiform stomach during esophagectomy.Methods From Septemper 2008 to December 2009,310 patients with esophageal carcinoma in middle and lower thoracic region underwent esophagectomy.155 patients underwentesophagogastric anastomosis with gastric tube,the other 155 patients underwent esophagogastric anastomosis with tradition stomach.All patient′s respiratory and cardiac function were detected 1 week before operation and 3 month,and 6 month after operation.With the modified EORTC QLQ C-30 method esophageal quality of life after 6 months of evaluation.Results All patients were survival without hospital death.pulmonary and cardiac function was no significant difference at the 1 week before operation(P>0.05).There were significant difference at the 3 month and 6 month after operation(P<0.05).Emotional functions,the body function and reflux symptoms of Esophagogastric anastomosis with gastric tube were better than those of control group.Conclusion Esophagogastric anastomosis with gastric tube have little effect on respiratory and cardiac function than with the tradition stomach after esophagectomy.It could improve the postoperative quality of life.