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目的研究预防食管-胃吻合术后反流性食管炎的吻合方式。方法 2000年3月-2009年8月,对食管下段癌5例,贲门癌25例,Barrett食管行癌肿切除1例,食管-胃肌瓣胃腔内瓣膜式吻合术,并对其中20例患者术后14～547d(平均44.9d)在吻合口上方5cm、吻合口、吻合口下方的胃腔内行压力测定。结果吻合口与吻合口下方的静息压相似,差异无统计学意义(P>0.05),而吻合口上方静息压增高,平均为1.886kPa,与吻合口上方和吻合口下方比较差异有统计学意义(P<0.001)。结论食管-胃肌瓣胃腔内瓣膜式吻合术是预防反流性食管炎严重吻合口并发症的有效手术方法。
Objective To study the anastomosis of reflux esophagitis after esophageal-gastric anastomosis. Methods From March 2000 to August 2009, 5 cases of lower esophageal cancer, 25 cases of cardia carcinoma, 1 case of Barrett’s esophagus underwent cancer resection, and 12 cases of esophageal-gastric myofascial flap anastomosis. Patients 14 ~ 547d after surgery (average 44.9d) above the anastomosis 5cm, anastomosis, stomach under the anastomosis line pressure measurement. Results The anastomotic pressure was similar to that of anastomotic stoma, but the difference was not statistically significant (P> 0.05). However, the resting pressure above the anastomotic stoma was 1.886 kPa, which was statistically different from those above the anastomotic and below the anastomotic Significance (P <0.001). Conclusion The intragastric valve anastomosis of the esophagus - gastric muscle flap is an effective surgical method to prevent the severe anastomotic complications of reflux esophagitis.