[采用Nissen胃底折叠术逆行吻合对食管胃吻合口的抗反流作用]

[Anti-reflux effects of reverse stapling with Nissen fundoplication for esophagogastric anastomoses].

作者信息

Wu Sen, Chen Ming-yao, Wei Li, Chen Zhong

机构信息

Thoracic Tumor Center, Henan Provincial People's Hospital, Zhengzhou 450003, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Dec 20;91(47):3350-3.

PMID:22333203

Abstract

OBJECTIVE

To explore the anti-reflux effects of esophagogastric anastomoses by reverse stapling with Nissen fundoplication (RSNF).

METHODS

A total of 103 cases of lower esophageal carcinomas and esophagogastric junction carcinomas undergone reverse stapled anastomoses with Nissen fundoplication between July 2009 and December 2010 at our hospital were retrospectively reviewed. And fistula, stricture and gastroesophageal reflux were compared with those of 130 traditional cases.

RESULTS

RSNF required more time than the traditional group (16.42 vs 14.02 min, P < 0.001). No fistula was found in neither group. There were 13 complications in RSNF and 23 in the traditional group (χ(2) = 0.44, P = 0.58). The rate of stricture was 4.8% (5/103) in RSNF and 6.9% (9/130) in the traditional group (χ(2) = 0.44, P = 0.58). There were 16 reflux esophagitis (15.5%) in RSNF and 29 in the traditional group (22.3%) (χ(2) = 2.57, P = 0.46). The post-RSNF reflux symptoms were more severe than the traditional group (31.1% vs 49.2%, χ(2) = 7.825, P = 0.007, score of GerdQ>8).

CONCLUSION

Reverse stapling with Nissen fundoplication may be conveniently performed with definite anti-reflux effects for esophagogastric anastomoses.

摘要

目的

探讨采用Nissen胃底折叠术逆行吻合（RSNF）行食管胃吻合术的抗反流效果。

方法

回顾性分析2009年7月至2010年12月在我院行Nissen胃底折叠术逆行吻合的103例食管下段癌和食管胃交界癌患者。并将吻合口瘘、狭窄和胃食管反流情况与130例传统手术患者进行比较。

结果

RSNF组手术时间比传统组更长（16.42分钟对14.02分钟，P<0.001）。两组均未发现吻合口瘘。RSNF组有13例并发症，传统组有23例（χ²=0.44，P=0.58）。RSNF组狭窄发生率为4.8%（5/103），传统组为6.9%（9/130）（χ²=0.44，P=0.58）。RSNF组有16例反流性食管炎（15.5%），传统组有29例（22.3%）（χ²=2.57，P=0.46）。RSNF术后反流症状比传统组更严重（31.1%对49.2%，χ²=7.825，P=0.007，GerdQ评分>8）。