管状胃－食管吻合术与全胃－食管吻合术对食管中段癌患者术后胃食管反流的对比研究

目的探讨管状胃－食管吻合术与全胃－食管吻合术对食管中段癌术后患者胃食管反流(GER)的影响。 方法回顾性分析2014年1月—2017年1月在新疆维吾尔自治区人民医院胸外科行食管癌切除术的56例食管中段癌患者的临床资料，其中观察组(管状胃－食管吻合术)患者27例，对照组(全胃－食管吻合术)患者29例，术后2周进行24 h胃－食管腔pH值监测，术后2周和1、3、6个月依据胃食管反流病调查问卷(GerdQ)评分表对患者的GER相关症状进行评分，比较两组患者术后GER发生情况。 结果所有患者获得随访，观察组和对照组术后2周时24 h酸反流次数、最长酸反流时间和pH值<4的总时间均显著少于对照组，差异有统计学意义(P<0.05)；术后1、3、6个月时，观察组GerdQ评分均显著低于对照组，差异也有统计学意义(P<0.05)。 结论管状胃－食管吻合术可显著降低食管中段癌患者术后GER的发生及严重程度。

A comparative study of gastroesophageal reflux after tubular gastroesophagostomy and full gastroesophagostomy for patients with middle esophageal cancer

ObjectiveTo investigate the effect of tubular gastroesophagostomy and full gastroesophagostomy on gastroesophageal reflux (GER) in patients with middle esophagus carcinoma. MethodsThe clinical data of 56 patients with middle esophageal cancer who underwent resection surgery in the Department of Thoracic Surgery, Xinjiang Uygur Autonomous Region from January 2014 to January 2017 were retrospectively analyzed. The patients were divided into the observation group (27 cases with tubular gastroesophagostomy) and the control group (29 cases with full gastroesophagostomy). The gastric-esophageal pH was monitored for 24 hours at the 2nd week postoperatively; the GER-related symptoms were scored based on the gastroesophageal reflux disease questionnaire (GerdQ) at the 2nd week, the 1st, 3rd, 6th month respectively after surgery. ResultsAll patients were followed up. The total times of acid reflux, the longest acid reflux time and the overall time with pH value <4 in 24 hours after 2 weeks postoperatively in the observation group were significantly lower than those in the control group.The differences were statistically significant (P<0.05); the GerdQ scores of the observation group were significantly lower than those in the control group at the 1st, 3rd and 6th month after operation (P<0.05). ConclusionsTubular gastroesophagostomy can significantly reduce the incidence and severity of postoperative GER in patients with middle esophageal cancer.