胃食管癌吻合术中吻合方式的选择与切口瘘的预防效果研究

目的 研究胃食管癌吻合术中吻合方式的选择与切口瘘的预防效果.方法 2007年至2012年收治的150例患者随机分为实验组和对照组各75例,对照组接受传统胃食管吻合术,实验组接受吻合器单层食管胃吻合术,对比两组患者术后吻合口瘘和狭窄等情况.结果 对照组发生吻合口瘘4例（5.33％）,胃食管反流8例（10.67％）,实验组无一例吻合口瘘,胃食管反流7例（9.33％）.实验组吻合口瘘发生率显著低于对照组（P＜0.05）,胃食管反流发生率与对照组相近（P＞0.05）.对照组术后发生轻度狭窄4例,中度狭窄2例,重度狭窄1例,共7例（9.33％）,实验组仅发生轻度狭窄1例（1.33％）,狭窄发生率显著低于对照组（P＜0.05）.结论 单层胃食管吻合术更接近生理结构,能减少吻合口瘘、吻合口狭窄等并发症发生率,胃食管反流发生率相近.

Research on the preventive effect of arch monolayer varus gastroesophagostomy on esophageal cancer for stomas fistula

Objective To study the preventive effect of arch monolayer varus gastroesophagostomy （AMVG） for fistulous on esophageal cancer.Methods 150 patients from 2007 to 2012 were randomly divided into 2 groups.The control group was treated with traditional gastroesophagostomy while the experimental group was treated with AMVG.The untoward reactions were observed.Results The control group had 4（5.33%）stomas fistula and 8（10.67%） gastro-esophageal reflux （GFR） while the experimental group had none （0%）fistula and 2（2.67%） GFR.The experimental group had a significant lower fistula rate （P〈0.05） and lower GFR rate than those of the control group （P〈0.05）.The experimental group had significant less stomas narrow of 1.33% than control group （9.33%） （P〈0.05）.Conclusion The AMVG makes a more natural stomas structure and reduces complication rate such as stomas fistula,narrow and GFP.