带蒂空肠短袖包被预防食管胃吻合口并发症的研究

目的:探讨"带蒂空肠短袖"防止食管贲门癌手术发生吻合口瘘、狭窄和反流的效果。方法:随机将651例食管贲门癌患者分为2组。对照组321例,仅进行传统的食管、贲门癌切除及食管胃吻合术;带蒂空肠短袖组330例,行食管贲门癌切除及食管胃吻合后,在吻合口表面套"带蒂空肠短袖",手术后分析2组患者术后并发症的发生率。结果:带蒂空肠短袖组患者手术后吻合口瘘、狭窄和反流的发生率分别为0.6%(2/330)、3.6%(12/330)和12.5%(40/321),对照组分别为4%(13/321)、10.9%(35/321)和12.5%(40/321),两组比较差异有统计学意义,P均<0.01。结论:"带蒂空肠短袖"外套食管胃吻合口,能明显降低吻合口瘘的发生,同时也明显降低术后反流、狭窄的发生,有较强的实用价值。

Study of "jejunal short sleeve with vessel pedicle" in preventing anastomotic complication of esophageal and cardia cancer after operation

OBJECTIVE: To discusses the effects of "jejunal short sleeve with vessel pedicle" in preventing anastomotic leakage,stenosis,esophageal reflux in patients with esophageal and cardia cancer after operation.METHODS:A total of 651 patients with esophageal or cardia cancer were divided into 2 groups,the control group with 321 patients underwent the operation according to the traditional oesophagectomy or cardiectomy and esophagogastrostomy,the "jejunal short sleeve with vessel pedicle" group with 330 patients underwent the operation in the foundation of traditional oesophagectomy or cardiectomy and esophagogastrostomy,adding the ejunal short sleeve with vessel pedicle outside the anastomotic stoma,and then the incidence in the complication in the two groups was analysed.RESULTS: The incidence of anastomotic leakage,stenosis,esophageal reflux in the "jejunal short sleeve with vessel pedicle" group were 0.6%(2/330),3.6%(12/330),12.5%(40/321),respectively;compared with 4%(13/321),10.9%(35/321),12.5%(40/321) of the control group,P<0.01.CONCLUSION: Jejunal short sleeve with vessel pedicle outside the anastomotic stoma can reduce the incidence of anastomotic leakage,stenosis,esophageal reflux in the patients with esophageal or cardia cancer after operation.