双成形术在食管胃手术中的应用

目的评价双成形术对食管胃术后胃排空障碍、吻合口瘘、狭窄及反流性食管炎的预防作用。方法按食管胃弓上、弓下及颈部吻合口部位将所有患者随机分为对照组和研究组，两组均采用手术切除的方法进行治疗，两组患者切除病灶后均应用国产管状吻合器将食管胃吻合在一起。对照组采用常规的食管贲门癌根治术；研究组患者在施行食管贲门癌根治术的同时，附加双成形术。结果研究组患者出现胃排空障碍1例，占0.43%，反流性食管炎1例，占0.43%，吻合口瘘1例，占0.43%，吻合口狭窄9例，占3.90%；对照组患者出现胃排空障碍8例，占3.57%，反流性食管炎7例，占3.13%，吻合口瘘9例，占4.02%，吻合口狭窄10例，占4.46%。两组胃排空障碍、反流性食管炎及吻合口瘘的发生率比较差异有统计学意义（P<0.05），吻合口狭窄的发生率比较差异无统计学意义(P>0.05)。结论采用双成形术可有效预防食管胃吻合后胃排空障碍，减少食管胃吻合口瘘及反流性食管炎的发生，不增加吻合口狭窄的发生率。

Double Angioplasty in Esophagus and Stomach Surgery Clinical Application

Objective To assess the effects of angioplasty double gastric emptying barrier on stomach esophagus,the anastomosis,narrow and the flowing esophagitis.Methods Patients cured by radical resection of cardiaoesophagus carcinoma was used for control group.The treatment group: patients were treated by radical resection of cardiaoesophagus carcinoma combined with double angioplasty.Results In treatment group,one patient appears gastric emptying obstacles,one is flowing esophagitis,one is anastomotic fistula,and the percentage was 0.43%,repectively.Nine cases appear anastomotic stenosis,about 3.90%;In control group,gastric emptying obstacles is 8 cases,about 3.57%,the flowing esophagitis is 7 patients,about 3.13%,anastomosis(9 cases,about 4.02%,anastomotic stenosis is 10 cases,about 4.46%.Two groups of comparisons gastric emptying disorders,the flowing esophagitis and anastomosis likely to have a significant difference(P<0.05),anastomotic stenosis no significant difference of chance(P>0.05).Conclusion Double angioplasty can effectively prevent esophageal angioplasty after stomach stapling gastric emptying,reduce barriers esophageal stomach anastomosis and the flowing esophagitis happening,decrease the incidence of anastomosis stricture.