管状胃吻合对食管胃结合部腺癌患者术后生活质量的影响

目的 比较食管胃结合部腺癌 （AEG）患者经腹近端胃切除后行管状胃吻合和传统胃吻合术后生活质量的差异。 方法 对112例 （2010年1月至2011年2月）经我院确诊为AEG （Siewert Ⅱ/Ⅲ型）、并行根治性手术患者 （均行近端胃切除术），按消化道重建方式分为传统食管胃吻合组 （52例）和管状胃吻合组 （60例）。采用中文版EORTC QLQ-C30及EORTC QLQ-STO22联合评价2组患者术前及术后2年生活质量。 结果 2组患者的基本资料、临床病理特征及术前生活质量差异均无统计学意义（P>0.05）。术后2年，管状胃吻合组患者反流症状、身体形象和恶心呕吐量表评分低于传统食管胃吻合组（P<0.05）。2组患者在整体健康状态、躯体功能、角色功能、疲倦、疼痛等方面上差异均无统计学意义（P>0.05）。 结论 近端胃切除后采用管状胃吻合，可以使患者的术后生活质量得到明显改善，值得临床推广。

Quality of Life of Patients with Gastric Tube Anastomosis after Proximal Gastrectomy in Adenocarcinoma of Esophagogastric Junction

Objective To compare postoperative quality of life (QOL) of patients receiving proximal gastrectomy (PG)for adenocarcinoma of gastroesophagealjunction (AEG) throughgastric tube anastomosis and traditional esophagogastrostomy. Methods Between January 2010 and February 2011, 112 patients were diagnosed as AEG in our hospital. All patients underwent curative operations. Two post-PG alimentary tract reconstruction methods were adopted: gastric tube anastomosis (n=60) and traditional direct anastomosis (n=52). The European Organization for Research and Treatment of Cancer (EORTC) Quality of life Questionnaire Core-30 (EORTC QLQ-C30) and QLQ-STO22 were used to assess QOL of those patients before and two years after operations.Results There were no statistically significant differences between the two groups of patients in clinical and pathologic characteristics, clinical pathological characteristics and preoperative QOL (P>0.05). Two years after operations, the patients receiving traditional direct anastomosis showed higher scores in reflux, body image, and nausea and vomiting compared with those receiving gastric tube anastomosis. No statistical differences were found between the two groups of patients in general health, physical function, role function, fatigue and pain (P>0.05).Conclusion Gastric tube reconstruction could improve the postoperative QOL of AEG patients.