贲门癌切除、食管胃粘膜吻合术626例结果评价

目的为减少贲门癌切除术后吻合口并发症，提高术后生活质量。方法自1991年8月至1999年6月，626例贲门癌切除术采用食管胃粘膜吻合术。主要步骤为常规切除贲门部癌肿后，剥除胃吻合口边缘3cm长的浆肌层，行食管壁全层和胃粘膜层端-端吻合术，将3cm长的吻合口置入胃腔内。结果术后近期并发症发生率10.1%(63/626)，住院死亡率0.6%(4/626)。其中吻合口瘘发生率0.3%(2/626)，吻合口狭窄发生率0.5%(3/626)。对存活病人随访3月～5年，无明显返酸、胸骨后疼痛等症状，无远期吻合口瘢痕狭窄发生。结论采用食管胃粘膜吻合术预防贲门癌切除术后吻合口并发症具有较好的效果。

Mucous esophagogastrostomyafter resect ion of cardiac cancer:Analysis of 626 cases

Objective　To reduce the anastomotic complications and increase patient′s quality of life after resection of cardiac cancer.Methods　626 cases mucous esophagogastrostomy had been performed in A nyang Ca ncer Hospital from Aug.1991 to Jun.1999.Main procedure were as follows:About 3cm le ngth seromuscular layer of the gastric anastomotic magin was removed.The end-to -end anastomosis of whole esophageal layer to gastric mucous layer was perform ed.More than 3cm length of anastomotic region then was inserted into the gastric cavit y.Results　The rate of postoperative complication and ho spital mortality were 1%(63/626) and 0.6%(4/626) respectively.The rate of anasto moti c leakage and anastomotic stricture were 0.3% (2/626) and 0.5 (3/626) respective ly.Postoperative follow-up had lasted 3-month to 5-year for living patients. Neither of them had symptom of regurgitation,pain behind the sternum and anastomotic stricture.Conclusions　Mucous esophagogastomy i s effective to prevent anastomotic complications after resection of the cardiac cancer.