Hirai T, Iwata T, Yamashita Y, Mukaida H, Saeki S, Toge T
Department of Surgery, Hiroshima University, Japan.
Hiroshima J Med Sci. 1992 Jun;41(2):25-30.
One hundred and fifteen patients with esophageal cancer underwent esophageal replacement with the stomach. The patients were divided into group A (52 patients, stomach tube, ante- or retro-sternal route) and group B (54 patients, devascularized upper half of the whole stomach, posterior mediastinal route). The post-operative complications, post operative symptoms and nutritional status were investigated in both groups. Lung complications tended to occur more frequently in group A (28.8% versus 22.2%), showing no significant difference. The incidence of other complications did not show a remarkable difference between either group except for leakage at the site of anastomosis. Major leakage occurred in 11.5% and 5.6%, and minor leakage in 30.8% and 18.5%, respectively. Postprandial fullness, nausea, heart burn and diarrhea were found to be somewhat higher in Group B. Change of oral intake, body weight and other indices of nutritional status were investigated and compared with pre- operative data. The amount of oral intake and levels of serum albumin was higher in group B than in group A between one and 12 months. These results demonstrate the superiority of the devascularized upper half of the whole stomach as an esophageal substitute.
115例食管癌患者接受了胃代食管手术。患者被分为A组（52例，采用胃管，经胸骨前或胸骨后途径）和B组（54例，采用去血管化的全胃上半部分，经后纵隔途径）。对两组患者的术后并发症、术后症状和营养状况进行了调查。肺部并发症在A组的发生率更高（28.8%对22.2%），但差异无统计学意义。除吻合口漏外，两组其他并发症的发生率无显著差异。严重漏发生率分别为11.5%和5.6%，轻微漏发生率分别为30.8%和18.5%。发现B组餐后饱胀、恶心、烧心和腹泻的发生率略高。对两组患者的经口摄入量变化、体重及其他营养状况指标进行了调查，并与术前数据进行了比较。术后1至12个月，B组的经口摄入量和血清白蛋白水平均高于A组。这些结果表明，去血管化的全胃上半部分作为食管替代物具有优越性。
