关键词: 食管肿瘤, 胃食管反流, 管状胃

Abstract: Objective  To investigate the clinical treatment effect of tubular stomach substitute for esophagus anastomosis in the radical surgery of esophageal cancer. Methods  Ninetyseven patients diagnosed with esophageal cancer in the First Affiliated Hospital of Soochow University from June 2013 to June 2015 were selected. They were divided into two groups, 51 patients using the gastric tube substitute for esophagus anastomosis in the gastric tube group, and 46 patients using the traditional full stomach substitute for esophagus anastomosis in the whole stomach group. The operation times, intraoperative blood losses, the amount of postoperative gastrointestinal decompression, hospital stays, pathologic stages and incidences of complications after surgery in the two groups were observed and compared. Results  There were no preoperative death in the two groups. The gastric tube group took more operating time than the whole stomach group ［(287.43±23.64)min vs. (266.13±26.47)min］, with a significant difference (t=2.279, P=0.031). In the comparison of the amount of gastrointestinal decompression, the gastric tube group was less than the whole stomach group ［(1 908.14±327.97)ml vs. (2 221.93±323.87)ml］, with a significant difference (t=-2.591, P=0.015). There were not significant differences in blood losses ［(325.00±64.30)ml vs. (356.67±49.52)ml; t=-1.490, P=0.147］, the numbers of lymph nodes ［(10.73±4.83) vs. (10.36±5.31); t=0.238, P=0.813］, hospital stays ［(15.32±3.69)d vs. (16.45±3.80)d; t=-1.005, P=0.320］ and pathologic stages (P=0.713) in the gastric tube group and whole stomach group. The incidence of gastroesophageal reflux in the gastric tube group was significantly less than that in the whole stomach group, with a significant difference (1.96% vs. 15.22%; χ²=5.617, P=0.025). The occurrence of the complications like anastomotic leakage (5.88% vs. 10.87%; χ²=0.795, P=0.471), postoperative pulmonary complications (13.73% vs. 23.91%; χ²=1.661, P=0.296) and anastomotic stenosis (7.84% vs. 13.04%; χ²=0.707, P=0.510) had no statistical difference in the gastric tube group and whole stomach group. ConclusionIn  the surgical treatment of esophageal cancer, tubular stomach substitute for esophagus anastomosis is better than the full stomach substitute for esophageal surgery, which can improve the life quality of postoperative patients and is worthy of clinical promotion.

Key words: Esophageal neoplasms, Gastroesophageal reflux, Gastric tube