Comparative Study Of The Recent Complications Between Tubular Stomach And Traditional Whole Stomach Operation In Treatment Of Esophageal Carcinoma

Objective: A retrospective analysis of the tubular stomach substitute foresophagus anastomosis with the traditional full stomach substitute for esophagusanastomosis, comparing the recent complications.Methods: Review the73cases of postoperative esophageal carcinoma clinicalcomplications datas during January2009to January2013at the second affiliatedhospital of Dalian medical university, Department of thoracic surgery.41cases inobservation group with tubular stomach substitute for esophagus anastomosis,32casesin the control group with the traditional full stomach substitute for esophagusanastomosis, all patients had improvement following routine operation: blood routine,liver and kidney function, blood coagulation, blood gas analysis, gastroscope pathology,upper gastrointestinal radiography, upper abdomen CT scan, pulmonary function, chestCT scan. After eliminated operation taboos, treated with operation. Postoperative,treated with parenteral nutritional support and antibiotic prophylaxis, reexamined chestCT scan after3-5days, upper gastrointestinal radiography after8-10. Pathology weresquamous cell carcinoma in all patients, comparing the recent complications betweenthe tubular stomach substitute for esophagus anastomosis with the traditional fullstomach substitute for esophagus anastomosis. Such as anastomotic fistula, gastricemptying disorder, pulmonary complications, thoracic gastric fistula, arrhythmia, andpulmonary complications include: atelectasis, pulmonary infection, respiratory failure.Results: There was no perioperative death patients in both two groups. Tubularstomach group had1cases anastomotic fistula (2.4%),3cases gastric emptying disorder(12.2%),4cases pulmonary complications (9.8%),1cases thoracic gastric fistula(2.4%),3cases arrhythmia (7.3%). Traditional full stomach group had2cases anastomotic fistula (9.4%),8cases gastric emptying disorder (31.3%),9casespulmonary complications (28.1%),1cases thoracic gastric fistula (6.3%),8casesarrhythmia (25%).Conclusions: the tubular stomach substitute for esophagus anastomosis is closer tonormal physiology and anatomy requirements, smaller gastric dilatation, smalleroccupied thoracic volume, lighter pressure on heart and lung system, effectively preventand reduce cardiac and pulmonary complications, conducive to the pulmonaryexpansion after operative. The postoperative complication incidence was significantlylower in patients with esophageal carcinoma.