应用管状胃与全胃代食管颈部吻合术在食管癌根治术中的疗效对比
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摘要
目的对比食管癌根治术中应用管状胃与全胃代食管颈部吻合术(TGCA)的临床疗效。方法纳入2017年1月～2018年12月本院收治的行食管癌根治术治疗的食管癌患者80例作为研究对象,随机将患者分成研究组(n=40)与参照组(n=40);研究组予以管状胃代食管颈部吻合术治疗,参照组予以TGCA治疗。对比两组患者临床指标、血清学指标及并发症发生情况。结果参照组与研究组手术时间出血量以及术后下床活动时间对比均无见显著差异(P>0.05);两组患者术前、术后各血清学指标对比均无显著差异(P> 0.05);患者术后各血清学指标相比术前均存在显著差异(P <0.05);研究组术后并发症发生率显著低于参照组(P <0.05)。结论应用管状胃与TGCA的临床疗效与对血清学指标的影响相似,但管状胃代食管颈部吻合术在食管癌根治术的应用相比全胃代食管可较好地保留胃生理功能,减少术后并发症的发生。
Objective To compare the clinical effects of sleeve gastrectomy and total gastric replacement esophagogastrostomy(TGCA) in radical resection of esophageal cancer. Methods 80 patients with esophageal cancer treated by radical resection in our hospital from January 2017 to December 2018 were included as research objects, and the patients were randomly divided into study group(n=40) and reference group(n = 40); The study group was treated with tubular stomach replacing esophagus neck anastomosis, and the reference group was treated with TGCA. The clinical indexes, serological indexes and complications of the two groups were compared. Results There was no significant difference between the reference group and the study group in the amount of bleeding during operation and the time of ambulation after operation(P > 0.05). There was no significant difference in serological indexes between the two groups before and after operation(P > 0.05). There were significant differences in serological indexes after operation compared with those before operation(P < 0.05). The incidence of postoperative complications in the study group was significantly lower than that in the control group(P < 0.05). Conclusion The clinical effect of tubular stomach replacing esophagus neck anastomosis and TGCA is similar to the influence on serological indexes, but the application of tubular stomach replacing esophagus neck anastomosis in radical resection of esophageal cancer can better preserve gastric physiological function and reduce the occurrence of postoperative complications.
Objective To compare the clinical effects of sleeve gastrectomy and total gastric replacement esophagogastrostomy(TGCA) in radical resection of esophageal cancer. Methods 80 patients with esophageal cancer treated by radical resection in our hospital from January 2017 to December 2018 were included as research objects, and the patients were randomly divided into study group(n=40) and reference group(n = 40); The study group was treated with tubular stomach replacing esophagus neck anastomosis, and the reference group was treated with TGCA. The clinical indexes, serological indexes and complications of the two groups were compared. Results There was no significant difference between the reference group and the study group in the amount of bleeding during operation and the time of ambulation after operation(P > 0.05). There was no significant difference in serological indexes between the two groups before and after operation(P > 0.05). There were significant differences in serological indexes after operation compared with those before operation(P < 0.05). The incidence of postoperative complications in the study group was significantly lower than that in the control group(P < 0.05). Conclusion The clinical effect of tubular stomach replacing esophagus neck anastomosis and TGCA is similar to the influence on serological indexes, but the application of tubular stomach replacing esophagus neck anastomosis in radical resection of esophageal cancer can better preserve gastric physiological function and reduce the occurrence of postoperative complications.
引文
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[2]王冠华,叶晓锋,曹建桥,等.管状胃术式在食管癌切除颈吻合术中的应用[J].宁夏医科大学学报,2014,36(12):1377-1379.
[3]张建新,罗平,包铮.管状胃重建消化道在食管癌根治术中的应用价值[J].中国临床研究,2015,28(2):202-203.
[4]吴兵,霍翔,方德根,等.管状胃在食管癌切除颈部吻合术中的应用[J].江苏医药,2016,42(4):450-452.
[5]康美和.管状胃重建消化道在食管癌根治术中的应用价值[J].医学理论与实践,2017,30(10):1462-1463.
[6]王会恩,薛文飞,王志康,等.管状胃与次全胃代食管颈部吻合术在食管癌根治术中的比较观察[J].临床和实验医学杂志,2018,17(22):2427-2430.
[7]Zhang X C, Liang H F, Luo X D, et al. YY1 promotes IL-6expression in LPS-stimulated BV2 microglial cells by interacting with p65 to promote transcriptional activation of IL-6[J].Biochem Biophys Res Commun,2018,502(2):269-275.
[8]HaverkampL,SeesingMFJ,RuurdaJP,etal.Worldwide trends in surgical techniques in the treatment of esophageal and gastroesophageal junction cancer[J].Dis Esophagus,2017,30(1):1-7.