抗食管胃吻合术后返流的研究

 目的　研究食管癌贲门癌根治术抗返流的有效方法。方法　采用随机单盲对照研究 ,将 10 0例分为实验组 (抗返流组 )和对照组 (无抗返流组 )。对照组采用常规食管胃吻合法 ,实验组加抗返流术 ,即 :食管胃单层吻合后 ,再将胃壁呈斜形向上套在吻合口外建立Gubaroff瓣 ,并将胃大弯侧向上提 1 5～ 2 0CM与纵隔胸膜固定形成His角。结果　实验组 :无返流 4 4例 ,有返流 6例 ;对照组 :无返流 4例 ,有返流 4 6例 ,差异有非常显著性 (P <0 0 1) ,说明实验组抗返流作用明显优于对照组。结论　本组研究实验组在常规食管胃吻合的基础上加抗返流术 ,建立了Gubaroff瓣和His角 ,取得与Nissen术等同样的抗返流效果 ,是良好的抗返流方法。

Research on Resisting Reflux after the Anastomosis of Esophagus and Stomach

Objective To study the effective measures on resisting reflux after the radical operation of the esophageal and cardic carcinoma.Methods 100 patients were randomly divided into two group:control group(resisting reflux group) and experimental group(no resisting reflux group).Control group was adopted the routine anastomosis way of esophagus and stomach.Experimental group was adopted a new surgery procedure on tresisting reflux:After unlined anastomosis of esophagus and stomach,the anastomosis was covered with the stomach wall which was lifted tiltedly and upward to form Gubaroff valve and the greater omentum was lifted from 1.5cm to 2.5cm upward fixing with mediastinal pleura to form His angel.Results There were 44 patients without reflux and 6 patients with reflux in experimental group,4 patients without reflux and 46 patients with reflux in control group.It had significant difference between experimental group and control group.Conclusion Compared to the routine anastomosis way,the experimental group appended way of resisting reflux and built Gubaroff valve and His angel.It obtained similar effect of resisting reflux to Nissen skill.So it is a good way of resisting reflux,too.