摘要
目的总结管状胃重建消化道在食管癌根治术中的应用经验,并探讨其安全性和临床效果。方法选择2007年1月～2010年6月期间在我院接受手术治疗的434例胸段食管癌患者,分为管状胃组和传统全胃组,观察比较两组手术时间、术后住院时间、并发症发生率等临床指标。结果管状胃组与传统全胃组手术时间、术后住院时间和术后pTNM分期比较无统计学意义(P>0.05);管状胃组术中清扫淋巴结数量及阳性淋巴结数量均多于传统全胃组,差异有统计学意义(P<0.05)。管状胃组术后吻合口瘘、胸胃综合症、心肺并发症的发生率以及死亡率均低于传统全胃组(P<0.05)。管状胃组随访期内胸胃综合症、反流性食管炎、吻合口狭窄、肿瘤复发及远处转移和死亡发生率均低于传统全胃组(P<0.05)。结论管状胃重建消化道在食管癌根治术中不延长手术时间和住院时间,操作简单、安全,术后并发症发生率低,可改善患者的生活质量,提高生存率,值得临床推广。
Objective To summarize the clinical experience of gastric tube for reconstruction of the digestive tract in esophageal carcinoma radical operation by left thoracic incision,and explore its safety and clinical outcome.Methods From January 2007 to June 2010,434 cases of thoracic segment esophageal carcinoma patient received radical operation in our hospital were divided into the gastric tube group and the traditional whole stomach group.The clinical index including operation time,postoperative hospital stay time,the rate of postoperative complications between two groups was observed and compared.Results There was no statistically difference in the operation time,postoperative hospital stay time,and the case of pTNM staging between two groups.Compared with the traditional whole stomach group,the amount of dissected lymph node and the amount of postive lymph node in the gastric tube group were significantly increased（P0.05）,the rate of anastomotic leakage,thoracic stomach syndrome,heart and lung complications and mortality during postoperative earlier period were significantly decreased（P0.05）.During the follow-uping period,the rate of thoracic stomach syndrome,reflux esophagitis,anastomotic stenosis,carcinoma relapse,carcinoma distant metastase and death in the gastric tube group were lower than those in the traditional whole stomach group（P0.05）.Conclusion Gastric tube is simple and safe,doesn＇t prolong the operation time and hospital stay time.It has fewer complications.It can improve the patients＇ life quality and raise the survival rate.It has a good value in clinical application.
出处
《四川医学》
CAS
2011年第9期1369-1371,共3页
Sichuan Medical Journal
关键词
食管癌
管状胃
临床效果
esophageal carcinoma
gastric tube
clinical outcome
