食管胃高位胸顶吻合加纵膈胸膜减张覆盖应用于老年食管癌手术的临床观察

目的 探讨两种不同的手术方法治疗老年食管癌的疗效及预后.方法 选择2006年1月-2012年12月该院收治的102例老年食管癌患者作为观察对象,随机分为31例常规食管癌切除加食管胃吻合手术组（A组）和71例食管胃高位胸顶吻合加纵膈胸膜减张覆盖组（B组）,比较两组手术时间、术中出血量、导管引流量以及术后并发症发生率.结果 B组手术时间、术中出血及导管引流量均明显少于A组,差异有统计学意义（P＜0.05）;B组术后并发吻合口瘘的发生率显著低于A组,差异具有统计学意义（P＜0.05）.结论 食管胃高位胸顶吻合加纵膈胸膜减张覆盖术操作简便,手术创伤小,术后吻合口瘘和吻合口狭窄的发生率低,是老年食管癌行之有效的手术方法,值得临床推广.

Clinical Observation on High Thoracic Esophagogastric Anastomosis with Mediastinal Pleura Top Tension Reduced Cover Used in Elderly Esophageal Cancer Operation

Objeetlve To explore the curative effect and prognosis of two different operation methods in the treatment of elderly patients with esophageal carcinoma. Methods 102 elderly patients with esophageal cancer from January, 2006 to December, 2012 admitted in our hospital were selected as the observation objects, and were randomly divided into routine resection of esophageal cancer plus esophagogastric anastomosis operation group of 31 patients （group A） and esophageal and gastric high thoracic apex anastomosis with mediastinal pleural tension cover group of 71 patients （group B）. The operation time, the intraoperative blood loss, catheter drainage and the incidence of postoperative complication were compared between the groups. Results The operation time, intranperative blood loss and catheter drainage of group B were significantly less than those of group A, the differences were statistically signiicant （ P〈0.05）; the incidence of anastomotic stoma stula after operation of group B was signi cantly lower than that of group A, the difference was statistically signiicant （P〈0.05）. Condusion High thoracic esophagogastric anastomosis with mediastinal pleura top tension covering is easy to operate and have small trauma, low incidence of postoperative anastomotic leakage and stenosis, which is an effective operation method for elderly patients with esophageal carcinoma and worthy of clinical application.