Analysis Of Application Of Tubular Stomach In Esophageal Cancer Surgery

ObjectiveDiscusses the application of esophageal cancer resection to the reconstruction of digestive tract stomach tube and the traditional operation method in the aspect of the lymph node, operation time and postoperative complications and postoperative complications.MethodsRetrospective analysis of thoracic surgery between January 2010 and December 2010, 78 patients with esophageal cancer during, all were performed surgical treatment, no perioperative deaths. Collection of preoperative and postoperative patients with clinical data, observation group of 35 cases with tubular generation of esophageal carcinoma, stomach control group 43 cases with traditional full stomach esophagus anastomosis, all patients with preoperative routine blood, liver and kidney function, blood coagulation screening examination, infection, blood gas analysis, clear gastroscope pathological, upper gastrointestinal angiography and abdominal CT, pulmonary function, chest CT, such as routine preoperative examination, eliminate surgery taboo, surgical treatment. Given antibiotics to prevent infection, postoperative parenteral nutrition support treatment, such as postoperative review chest X-ray or chest CT 3-5, 8-10 yue review upper gastrointestinal angiography. Postoperative 1, 2, 3 month follow-up to determine the presence of gastroesophageal reflux, anastomotic stricture, complications such as recurrent parallel further treatment, postoperative pathology for 73 cases of squamous cell carcinoma, adenocarcinoma in 2 cases, glands squamous carcinoma(3 cases), contrast analysis of tubular stomach esophagus anastomosis with traditional full stomach generation esophageal carcinoma, the lymph node in operation time, and the postoperative complications of differences. ResultsTwo groups of patients, there were no perioperative death. Tubular stomach surgery time min, 152-241(194 + 35 min) on average, the traditional surgical operation time of 143-143 min, the average(186 + 32 min), no significant difference between the two. Lymph node cleaning the average number of tubular stomach group 15.5, 6.3, is little side the traditional full stomach group draw 13.6, 4.6, is little side is little number of lateral lymph node cleaning tubular stomach significantly more than the traditional stomach group. Tubular postoperative gastric group of thoracic stomach syndrome in 3 patients(8.6%), pulmonary complications(11.4%), 4 cases of cardiovascular complications in 2 cases(5.7%), gastric emptying dysfunction in 3 patients(8.6%), 5(14.3%) of gastroesophageal reflux. Traditional full stomach group of 8 cases of thoracic stomach syndrome(18.6%), 9 cases(20.9%), lung complications of cardiovascular complications in 7 cases(16.3%), gastric emptying disorder 7 cases(16.3%), gastroesophageal reflux 13(30.2%). ConclusionsTubular compared with the traditional full stomach generation of esophagus stomach without any increase in operating time, under the condition of lymph node cleaning the number more than the traditional whole generation of esophagus, stomach tube stomach generation of esophageal carcinoma is closer to the physiological anatomy, little stomach body expansion degree, occupying the chest volume small, the right light, lung compression system, to facilitate postoperative lung expansion, effectively prevent and reduce the complications of heart, lung, reduced the incidence of gastric emptying dysfunction, gastroesophageal reflux, significantly reduce the incidence of postoperative complications of patients.