管状胃重建在ⅡⅢ型食管胃结合部腺癌手术中应用.docVIP

管状胃重建在ⅡⅢ型食管胃结合部腺癌手术中应用 　　[摘要] 目的 评价管状胃重建在Ⅱ、Ⅲ型食管胃结合部腺癌手术中应用的效果。 方法 将2009年12月～2013年12月期间确诊为Ⅱ、Ⅲ型食管胃结合部腺癌的144例患者根据消化道重建方式分为两组，传统组（76例）行食管-残胃吻合，管状胃组（68例）则行食管-管状胃吻合，观察术后胃食管反流及反流性食管炎的发生率。 结果 两组患者的基本资料及临床病理特征比较，差异均无统计学意义（P0.05）。传统组食管-残胃吻合后有35.5%的患者出现胃食管反流，管状胃组有16.1%的患者出现胃食管反流，两组比较差异有统计学意义（P=0.041）；传统组食管-残胃吻合后有22.3%的患者经胃镜诊断为反流性食管炎，管状胃组有7.5%的患者经胃镜诊断为反流性食管炎，两组比较差异有统计学意义（P=0.038）。 结论 管状胃术式较传统残胃-食管吻合能明显降低患者术后胃食管反流及反流性食管炎的发生率，提高患者的生活质量，值得临床推广。 　　[关键词] 食管胃结合部腺癌；Siewert分型；消化道重建；外科手术 　　[中图分类号] R735.2 [文献标识码] A [文章编号] 1674-4721（2016）01（b）-0050-03 　　Application of tubular gastric reconstruction in Ⅱ，Ⅲ type gastric esophagus integration carcinoma operation 　　YIN Qing-hui1 ZENG Xiang-tai1 WANG Xue-zhong2 YE Bin1 LI Cai-sheng1 　　1.Department of First Surgery，the Second Hospital Affiliated to Gannan Medical College，Jiangxi Province，Ganzhou 341000，China；2.Department of First Chest Tumor，Xinxiang Central Hospital，Henan Province，Xinxiang 453000，China 　　[Abstract] Objective To evaluate the clinical effect of tubular gastric reconstruction in Ⅱ，Ⅲ type gastric esophagus integration carcinoma operation. Methods 144 cases of Ⅱ，Ⅲ type gastric esophagus integration carcinoma patients from December 2009 to December 2013 were divided into two groups by digestive tract reconstruction mode.Patients in traditional group （n=76） were conducted esophagus-residual stomach anastomosis.Patients in tubular gastric group （n=68） were conducted esophagus- tubular stomach anastomosis.The incidence rate of postoperative gastroesophageal reflux and reflux esophagitis were observed. Results Both of basic data and clinical pathological feature of patients in two groups had no statistical significance （P0.05）.35.5% patients had acid reflux symptoms after esophagus-residual stomach anastomosis in traditional group，16.1% patients appeared that after esophagus-tubular stomach anastomosis in tubular gastric group，the difference was statistically significant （P=0.041）.22.3% patients were diagnosed as reflux esophagi