改良非切割型管状胃在食管癌根治术中的应用

目的探讨改良非切割型管状胃与传统切割型管状胃在食管癌根治术中临床应用的可行性、安全性及短期临床效果。方法回顾性分析47例食管癌根治术病人的临床资料。所有病人术前均胃镜证实为食管癌。分为改良非切割型管状胃组24例，传统切割型管状胃组23例；分析2组病人手术时间、术中出血、管状胃长度、耗材用量及术后观察指标、出院短期随访等。结果全部病人均顺利完成手术，无术中大出血等意外情况发生；改良非切割型管状胃组手术时间、管状胃长度与耗材用量均少于传统切割型管状胃组（P < 0.05~P < 0.01）；2组术中出血、术后2 d胸腔引流总量及住院时间差异均无统计学意义（P>0.05）；改良非切割型管状胃组围术期和短期随访并发症发生率与传统切割型管状胃组差异均无统计学意义（P>0.05），无严重并发症及死亡病例。结论改良非切割型管状胃可缩短手术时间、降低耗材量，且不会增加吻合口瘘及狭窄、肺部感染、术后返酸、胸胃扩张等术后并发症。

Application of modified uncut tubular stomach in radical resection of esophageal carcinoma

ObjectiveTo investigate the feasibility, safety and short-term clinical effects of the application of modified uncut tubular stomach and traditional cut tubular stomach in radical surgery of esophageal carcinoma.MethodsThe clinical data of 47 patients treated with radical surgery of esophageal carcinoma were retrospectively analyzed.All patients with esophageal cancer were confirmed by gastroscopy before surgery.The patients were divided into the modified uncut tubular stomach group(24 cases) and traditional cut tubular stomach group(23 cases).The operation time, intraoperative bleeding, length of tubular stomach, material usage, postoperative observation index and short-term follow-up after discharge in two groups were analyzed.ResultsAll operations were successfully completed, no intraoperative bleeding and other accidents occurred.The operation time, length of tubular stomach and material usage in modified uncut tubular stomach group were less than those in traditional cut tubular stomach group(P < 0.05 to P < 0.01).The differences of the intraoperative hemorrhage, postoperative 2 d thoracic drainage amount, length of hospital stay, incidence rates of complications during perioperative period and short-term follow-up between two groups were not statistically significant(P>0.05).There was no serious complication or death.ConclusionsThe modified uncut tubular stomach can shorten the operation time and reduce the material usage, and does not increase the anastomotic fistula and stenosis, pulmonary infection, postoperative acid reflux, and chest and stomach dilation.