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目的对比分析食管胃颈部单层吻合术与传统吻合术治疗食管癌的疗效,探究临床治疗食管癌的有效吻合术式。方法根据吻合方式的不同,将2008年1月至2009年4月期间林州市中医院收治的151例食管癌患者分为观察组与对照组,前者包括患者83例,接受食管胃颈部单层吻合术治疗,后者包括患者68例,接受传统吻合术治疗。根据实际情况,所有患者在术后均接受适当的辅助治疗。治疗结束后对患者进行随访,随访期为3年,现对比分析两组患者的近期疗效及远期疗效。结果①两组患者手术时间、术中出血量、住院时间相比差异无统计学意义(P>0.05)。②两组患者术后体质量减轻、胃食管反流、腹泻、食欲下降等并发症发生率相比差异无统计学意义(P>0.05),但是观察组患者术后吻合口瘘、吻合口狭窄、进食困难等并发症发生率显著低于对照组,两组之间比较差异有统计学意义(P<0.05)。③两组患者随访期内复发率、转移率、1年生存率、3年生存率相比差异无统计学意义(P>0.05)。结论食管胃颈部单层吻合术与传统吻合术治疗食管癌具有相近的手术指标,远期疗效比较差异亦无统计学意义,但是前者术后吻合口瘘、吻合口狭窄、进食困难等并发症发生率较低,对提高患者术后生存质量有着十分重要的意义。
Objective To compare the curative effect of esophagogastric stomach anastomosis and traditional anastomosis in the treatment of esophageal cancer and explore the effective anastomosis of esophageal cancer. Methods According to the different anastomosis methods, 151 cases of esophageal cancer treated in Linzhou Hospital of Traditional Chinese Medicine from January 2008 to April 2009 were divided into the observation group and the control group. The former included 83 patients and received esophagogastrophobia Stratum anastomosis treatment, the latter including 68 patients, to accept the traditional anastomosis treatment. According to the actual situation, all patients received appropriate adjuvant therapy after surgery. The patients were followed up after the treatment, the follow-up period was 3 years, and the short-term curative effect and long-term curative effect of the two groups were compared. Results ① There was no significant difference in operative time, intraoperative blood loss and hospital stay between the two groups (P> 0.05). ② There was no significant difference in the incidence of complications such as body weight loss, gastroesophageal reflux, diarrhea and loss of appetite between the two groups (P> 0.05), but the postoperative anastomotic fistula, anastomotic stenosis , Complications such as eating difficulties were significantly lower than the control group, the difference between the two groups was statistically significant (P <0.05). ③ There was no significant difference in recurrence rate, metastasis rate, 1-year survival rate and 3-year survival rate between the two groups at follow-up (P> 0.05). Conclusion Esophageal and gastric anastomosis with traditional anastomosis for esophageal cancer has similar surgical indicators, the long-term efficacy was no significant difference, but the former anastomotic fistula, anastomotic stenosis, eating difficulties and other complications The lower incidence of postoperative patients to improve the quality of life is of great significance.