Comparative Study Of Wide And Narrow Tube Of Stomach Complications

ObjectiveDiscussion on patients with esophageal carcinoma row subtotal esophageal chest ways, neck anastomosis wide production, analysis and comparison of the narrow tubular stomach recent major postoperative complication rates, provide a meaningful reference for clinical surgery. Materials and MethodsSetting exclusion and inclusion criteria, and select prospective analysis from February 2015 to December 2015 in our hospital 119 cases of surgical treatment of patients with esophageal carcinoma clinical data were compared. All patients underwent preoperative improve the relevant inspection, such as: blood, coagulation, liver and kidney function, electrocardiogram(if necessary coronary angiography), upper gastrointestinal radiography, chest and upper abdominal CT, fiber gastroscope and other routine preoperative an examination. Randomized, 56 cases in which the surgery done broadly tubular stomach and neck, esophageal, and do 63 cases of narrow tubular stomach and esophagus anastomosis neck. Ways were taken to the left chest subtotal esophagus, neck anastomosis surgical + two-field lymph node dissection, intraoperative use the Johnson linear stapler closure(TLC-55) to produce a tubular stomach, where gastric tube diameter wide ≥6cm, narrow stomach tube diameter ≦ 4cm, esophagus anastomosis neck diameter according to the size or type selected Johnson SDH21 SDH25 model to fit the circular stapler. It was observed after the wide and narrow tubular stomach two recent incidence(during hospitalization) major complications. Such as: anastomotic fistula, pulmonary complications(pneumonia, atelectasis, ARDS, respiratory failure), the stomach contents reflux, recurrent laryngeal nerve injury, arrhythmia. Application SPSS17.0 software for statistical analysis, measurement data using mean ± standard deviation(`x ± S) t test, count data using c2 test, with a = 0.05 level for the test, p <0.05 was considered statistically significant. ResultsWide and narrow group of patients with gastric tube no perioperative deaths occurred, a wide group of patients with gastric tube anastomotic fistula in 2 cases(3.7%), pulmonary complications four cases(7.5%), 4 cases of gastric contents reflux(7.5%), recurrent laryngeal nerve injury in 7 cases(12.5%), arrhythmia 5 cases(9.4%). Narrow group of patients with gastric tube anastomotic fistula in 6 cases(9.5%),Wherein the tubular necrosis in 2 cases of gastric resection margin,pulmonary complications occurred in 5 cases(7.9%), stomach contents reflux 4 cases(6.3%), 10 cases of recurrent laryngeal nerve injury(15.9%) arrhythmia 5 cases(7.9%). Wide and narrow tubular anastomotic leakage rate difference was statistically significant(P = 0.012 <0.05, c2 = 65.73); the incidence of pulmonary complications was no significant difference(P = 0.33> 0.05,2c2= 2.83); The incidence of regurgitation of stomach contents showed no significant difference(P = 0.18> 0.05,c2 = 18.17); the incidence of recurrent laryngeal nerve injury was no significant difference(P = 0.08> 0.05,c2 = 33.6); arrhythmia Health rate difference was not statistically significant(P = 0.21> 0.05,2c2= 14.5).ConclusionsPatients with esophageal carcinoma line subtotal esophageal chest ways, broadly tubular neck anastomosis can reduce the production of stomach incidence of anastomotic fistula, narrower than the tubular stomach. And pulmonary complications, stomach contents reflux, recurrent laryngeal nerve injury, no difference in the incidence of arrhythmia. So make your stomach broadly tubular neck and esophageal anastomosis in the surgery is worth promoting, but also to provide clinically meaningful surgical reference.