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目的探讨左进胸一切口食管床途径行胃与食管吻合对食管癌根治术的影响。方法选取2008年6月至2012年6月收治的180例食管癌患者,随机分为观察组(90例)和对照组(90例)。对照组患者采用常规手术方式,观察组患者采用左进胸一切口食管床途径行胃与食管吻合术。对两组患者术中情况、术后并发症和近期随访结果进行比较。结果观察组患者手术时间、术中出血量和平均住院时间均低于对照组,差异有统计学意义(P<0.05)。观察组患者术后并发症发生率显著低于对照组(P<0.05),吻合口瘘和吻合口狭窄发生率也均低于对照组(P<0.05)。观察组患者食管胃区同位素比值低于对照组,差异有统计学意义(P<0.05)。观察组患者术后肺功能显著高于对照组(P<0.05)。结论左进胸一切口食管床途径行胃与食管吻合可以缩短手术时间,减少手术损伤,降低术后并发症发生率,改善患者生活质量。
Objective To investigate the effect of anastomosis between stomach and esophagus on esophagectomy with esophagectomy through all-mouth esophageal approach. Methods 180 patients with esophageal cancer admitted from June 2008 to June 2012 were randomly divided into observation group (90 cases) and control group (90 cases). The patients in the control group were treated by conventional surgery, and the patients in the observation group were treated with gastric bypass and esophageal anastomosis through the all-mouth esophageal approach. The two groups of patients intraoperative situation, postoperative complications and recent follow-up results were compared. Results The operation time, intraoperative blood loss and average length of hospital stay in the observation group were significantly lower than those in the control group (P <0.05). The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P <0.05), and the incidence of anastomotic fistula and anastomotic stenosis were also lower than those in the control group (P <0.05). The ratio of esophagogastric area in the observation group was lower than that in the control group, with significant difference (P <0.05). Lung function in observation group was significantly higher than that in control group (P <0.05). Conclusion All the approaches of esophageal approach to the esophagus with anastomosis can reduce the operation time, reduce the surgical injury, reduce the incidence of postoperative complications and improve the quality of life of patients.