【摘要】 目的:探讨管状胃代食管手术与全胃代食管术治疗食管癌的临床疗效。方法:分析桂林医学院附属医院心胸外科接受食管癌手术的109例患者的病例资料;按手术方式不同分为管状胃组(A组,56例)和全胃组(B组,53例),另选取健康成年人作为对照组(C组,52例)。比较管状胃组和全胃代食管组患者在术中吻合口位置、术中出血量、手术时间、胃肠减压量、术后胃肠减压时间、胸腔闭式引流管拔除时间、胸腔引流液量、术后并发症发生情况及术后1个月的肺功能等临床指标的差异。应用食管测压、24hpH值检测以及食管胃镜等方法,进行胸胃功能检测。结果:管状胃组患者术后,反流性食管炎等术后并发症的发生率低于全胃组,差异有统计学意义(P<0.05)。管状胃组和全胃组术后胸胃功能较对照组下降,但管状胃组疗效较好,3组相比较差异亦有统计学意义(P<0.05)。结论:不同术式食管癌术后胸胃功能均有不同程度下降,但管状胃代食管术后胸围功能较全胃代食管效果好。更多还原

【Abstract】 Objective:To investigate the therapeutic effect on patients with resectable esophageal cancer after esophagectomy fallowed by gastric tube or whole stomach reconstruction.Methods:This research retrospectively analysed patients underwent esophagectomy for esophageal cancer in our hospital.Patients were divided into to groups,group A,56 patients underwent gastric tube esophagectomy;group B,53 patients underwent whole stomach reconstruction esophagectomy.And 52 healthy adults was chosen as control group C.The clinical indexes such as the level of anas-tomosis,the intraoperative bleeding,operation time,postoperative thoracic drainage and gastrointestinal decompression,drainage tube removal time,postoperative complications and respiratory function 1months after surgeries in patients of two groups were observed and compared.Results:Patients in group A had lower rate of postoperative complications reflux esophagitis than patients in group B.The difference was statistically significant(P<0.05).Patients in group A had lower rate of thoracic stomach syndrome than patients in group B.The difference was statistically significant.The thoracic gastric function of group A and group B after surgery decreased compared with group C,but Group B decreased significantly,which were of statistical differences.Conclusion:Different operative methods for esophageal cancer can decline gastric function to some extent after esophagectomy,but the gastric tube is better than the whole stomach reconstruction.更多还原