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目的:观察胃管状成形重建(管状胃)在食管癌切除术中的应用效果。方法:选择食管癌、贲门癌116例,随机分为管状胃组和胸腔胃组各58例,比较两组手术时间、术中出血量、术中术后输血量、术中清除淋巴结数量及住院时间,并观察术后吻合口瘘、胸胃综合征等并发症发生情况。结果:管状胃组手术时间、术中出血量、术中术后输血量均显著或非常显著少于胸腔胃组(P<0.05,P<0.01);两组清除淋巴结数量及术后住院时间差异不显著(P>0.05)。管状胃组发生颈部吻合口瘘1例,胸胃综合征1例;胸腔胃组发生颈部吻合口瘘1例,肺不张2例,肺部感染4例,胸胃综合征6例;死亡1例。结论:食管癌切除术中,胃管状成形重建食管术式优于胸腔胃术式。
Objective: To observe the effect of gastric tubular reconstruction (tubular stomach) in the resection of esophageal cancer. Methods: One hundred and sixty-six patients with esophageal and cardiac cancer were randomly divided into tubular gastric group and 58 intra-abdominal gastric group. The operation time, intraoperative blood loss, intraoperative and postoperative blood transfusion, number of lymph nodes removed and hospitalization Time, and observed postoperative anastomotic fistula, thoracoital syndrome and other complications. Results: The operation time, intraoperative blood loss and intraoperative and postoperative blood transfusion volume were significantly or very significantly less than those of the thoracic gastric group (P <0.05, P <0.01); the number of lymph nodes and the length of postoperative hospital stay Not significant (P> 0.05). 1 case of cervical anastomotic fistula and 1 case of thoracoabdominal syndrome occurred in tubular stomach group, 1 case of anastomotic fistula in thoracic stomach group, 2 cases of atelectasis, 4 cases of lung infection and 6 cases of thoraco-gastric syndrome. 1 case of death. Conclusions: In esophageal resection, the reconstruction of esophagus by gastric tube is better than thoracostomy.