摘要
[目的]探讨幽门成形术在预防术后胃排空障碍中的作用。[方法]通过回顾性病例对照研究,403例纳入研究,将病例分为幽门成形(P)组:99例,非幽门成形(NP)组:304例,全组病例术后胃排空障碍68人(16.8%),幽门成形组18例(18/99,18.2%),非幽门成形组50例(50/304,16.4%);术后并发吻合口瘘13例(3.2%),幽门成形组4例(4%),非幽门成形组9例(3%);肺部感染29例(7.2%),幽门成形组7例(7%),非幽门成形组22例(7.2%);全组死亡3例,其中2例死于吻合口瘘,1例死于肺部感染,呼吸衰竭。[结果]幽门成形组胃排空障碍的发病率有略高于非幽门成形组的趋势,但P﹥0.05;幽门成形组和非幽门成形组两组间吻合口瘘或胃瘘的发生率无统计学差异(P﹥0.05);肺部感染的发生率在幽门成形组与非幽门成形组间无统计学差异(P﹥0.05)。[结论]本研究显示食管术中幽门成形在预防术后胃排空障碍,吻合口瘘或胃瘘以及在降低吸入性肺炎的发生率方面未见确切优势。
[Objective] To investigate the efficiency of pyloromyotomy in prevention postoperative delayed gastric emptying in patients with esophageal cancer. [Methods] Retrospective study was conducted, 403 patients underwent esophagectomy with gastric conduit were recruited to divided into two groups： Group NP had no pyloromyotomy （n = 304） and Group P had a pyloromyotomy （n = 99）. In the two groups, 68 patients with gastric emptying disorder （16.8%）, 18 patients with pylorus forming （18/99, 18.2%） and 50 patients with non-pyloms forming （3%） were founded; After operation, 29 patients were present with pulmonary infection （7.2%）, 7 cases with pylorus forming （7%） and 22 cases with with non-pylorus forming （7.2%）. In two groups, 3 cases died, out of them, 2 died due to anastomotic stoma fistula, and 1 case died became of pulmonary inffection and respiratory failure. [Results] The incidence of gastric emptying disorder in pylorus forming group was significantly higher than that in non-pylorus forming group （P 〉 0.05）, the incidences of pulmonary infection, anastomotic leaks and gastric fistula did not showed significant difference between pylorus forming group and non-pylorus forming group （P 〉 0.05）. [ Conclusion ] Pyloromyotomy does not reduce the incidence of symptomatic delayed gastric emptying after esophagectomy, no advantage were found in preventing anastomotic or gastric leaks and postoperative pneumonia by use of pyloromyotomy.
出处
《现代预防医学》
CAS
北大核心
2008年第12期2372-2373,共2页
Modern Preventive Medicine
关键词
食管癌
幽门成形术
胃排空障碍
Esophageal cancer
Pyloromyotomy
Delayed gastric emptying
