食管胃、空肠唇状吻合术的临床应用

目的探讨食管胃空肠吻合术对预防食管癌、贲门癌术后并发症的影响。方法54例食管癌、贲门癌患者采用食管胃、空肠唇状单层Gambee法吻合,食管胃吻合43例,食管空肠吻合11例。结果全组术后恢复顺利,无吻合口瘘、吻合口狭窄及明显反流性食管炎发生。术后3～12月钡餐检查示吻合口口径平均1.6(1.2～2.0)cm。54例平均随访5.8(1.5～8.0)年,术后3年、5年生存率分别为47.6%(20/42)和14.3%(14/28)。结论单层唇状吻合重建消化道有单层吻合和套入式吻合的双重优点,可防止吻合口瘘、吻合口狭窄和反流性食管炎的发生。

Clinical Application of Lip-shaped Esophagogastrostomy and Esophagojejunostomy

Objective To evaluate the effect of lip-shaped esophagogastrostomy and esophagojejunostomy on preventing postoperative anastomotic leakage, stricture and reflux esophagitis. Methods 54 patients with esophageal and cardia cancer were underwent resection with Gambee's single layer lip-shaped anastomosis, including esophagogastrostomy in 43 cases and esophagojejunostomy in 11 cases. Result There was no occurrence of leakage, stricture and apparent reflux esophagitis. The anastomotic caliber was 1.2 to 2.0 cm in diameter in consistent with Barium meal exam 3 to 12 months postoperatively. The 3-, 5-year survival were 47.6% and 14.3% respectively within 1.5 to 8.0 year follow-up. Conclusion This technique hire the advantages of both single layer and invaginate anastomosis, functioning very well to prevent anastomotic leakage,stricture and reflux esophagitis.