Jiang Sicong, Guo Changying, Zou Bin, Xie Jianguo, Xiong Zhihui, Kuang Yukang, Tang Jianjun
Department of Thoracic Surgery, Jiangxi Cancer Hospital of Nanchang University, No. 519 Beijing East Road, Nanchang, 330006, Jiangxi, China.
Department of Obstetrics, Tongde Hospital of Zhejiang Provience, Zhejiang, 310012, Hangzhou, China.
BMC Surg. 2020 Jul 16;20(1):156. doi: 10.1186/s12893-020-00810-y.
At present, the gastric tube is the first choice for esophageal reconstruction after esophagectomy for various benign and malignant diseases. However, when the stomach is not available, a pedicled jejunum or colon is used to reconstruct the esophagus. The present study aimed to compare the postoperative outcomes and quality of life of patients receiving jejunal and colonic conduits.
In the present retrospective study, the clinical data of 71 patients with esophageal carcinoma, who received jejunal reconstruction (jejunum group, n = 34) and colonic reconstruction (colon group, n = 37) from 2005 to 2015, were compared.
Compared with the colon group, the jejunum group had a lower incidence of postoperative anastomotic leakage, lesser duration of postoperative drainage, and faster recovery. Furthermore, the scores were better in the jejunum group than in the colon group, in terms of short-term overall quality of life, physical function and social relationships. Moreover, the jejunal group had a significantly lower frequency of pH < 4 simultaneous reflux time > 5 min (N45) and the longest reflux time (LT) at 24 weeks after surgery.
In esophageal cancer, when gastric tube construction is not feasible, a pedicled jejunum may be preferred over a colonic conduit due to lower incidence of acid reflux, anastomotic leakage and higher postoperative short-term quality of life, and rapid postoperative recovery.
目前，胃管是各种良恶性疾病食管切除术后食管重建的首选。然而，当无法利用胃时，则采用带蒂空肠或结肠来重建食管。本研究旨在比较接受空肠和结肠管道重建患者的术后结局及生活质量。
在本回顾性研究中，比较了2005年至2015年间71例接受空肠重建（空肠组，n = 34）和结肠重建（结肠组，n = 37）的食管癌患者的临床资料。
与结肠组相比，空肠组术后吻合口漏发生率更低，术后引流时间更短，恢复更快。此外，在短期总体生活质量、身体功能和社会关系方面，空肠组的评分优于结肠组。而且，空肠组术后24周时pH < 4且同时反流时间> 5分钟（N45）的频率显著更低，反流最长时间（LT）也最短。
在食管癌中，当无法进行胃管构建时，由于酸反流、吻合口漏发生率较低，术后短期生活质量较高且术后恢复较快，带蒂空肠可能比结肠管道更受青睐。
