管状胃食管吻合术对食管癌根治术后患者并发症的影响

目的:探讨管状胃食管吻合术对食管癌根治术后患者并发症的影响。方法:选择巴中市中心医院确诊为中下段食管癌并有手术指征的患者94例,随机分为改良组和对照组,每组47例。改良组术中采用管状胃食管吻合术,对照组采用传统的全胃食管吻合术。比较术后1个月两组患者肺功能、胃食管反流及其他并发症的发生率。结果:与术前比较,两组术后1个月肺功能明显降低,差异有统计学意义(P<0.05);与对照组比较,改良组术肺功能明显增加,差异有统计学意义(P<0.05)。改良组术胃食管反流的发生率明显低于对照组,差异有统计学意义(P<0.05),两组肺部感染和吻合口漏发生率差异无统计学意义。结论:管状胃食管吻合术能明显减轻食管癌根治术后患者肺功能损害,减少胃食管反流的发生,不会增加严重不良反应的发生率,适合在食管癌根治术中应用。

The Effect of the Gastric Tube Gastroesophagostomy on Complications after Radical Resection of Esophageal Carcinoma

Objective:To investigate the effect of the gastric tube gastroesophagostomy on complications after radical resection of esophageal carcinoma.Methods:94 patients,who diagnosis with midand lower-thoracic esophageal cancer in Bazhong central hospital between October 2010 and October 2011,were randomized into gastric tube group and control group,47 in each.Gastric tube gastroesophagostomy were performed in the gastric tube group,and the standard gastroesophagostomy were received in the control group.The respiratory function,incidence of gastroesophageal reflux,and other complications were compared in 2 groups after operation for 1 month.Results:The respiratory function were significantly decreased in both groups,and the gastric tube demonstrated a better respiratory function compared with the contral group(P<0.05).The incidence of gastroesophageal reflux were lower in the gastric tube group(P<0.05).Other complications such as lung infection and anastomotic leakage were similar in both groups.Conclusion:Our data support the idea that the gastric tube gastroesophagostomy could alleviate the injury of respiratory function,reduce the incidence of gastroesophageal reflux in postoperative patients with esophageal carcinoma,without increasing serious side effects.This approach can be well applied in radical resection of esophageal carcinoma.