A comparative study of gastroesophageal reflux after tubular gastroesophagostomy and full gastroesophagostomy for patients with middle esophageal cancer

doi:10.3877/cma.j.issn.2095-8773.2018.03.05

Abstract

Abstract:

Objective

To investigate the effect of tubular gastroesophagostomy and full gastroesophagostomy on gastroesophageal reflux (GER) in patients with middle esophagus carcinoma.

Methods

The clinical data of 56 patients with middle esophageal cancer who underwent resection surgery in the Department of Thoracic Surgery, Xinjiang Uygur Autonomous Region from January 2014 to January 2017 were retrospectively analyzed. The patients were divided into the observation group (27 cases with tubular gastroesophagostomy) and the control group (29 cases with full gastroesophagostomy). The gastric-esophageal pH was monitored for 24 hours at the 2nd week postoperatively; the GER-related symptoms were scored based on the gastroesophageal reflux disease questionnaire (GerdQ) at the 2nd week, the 1st, 3rd, 6th month respectively after surgery.

Results

All patients were followed up. The total times of acid reflux, the longest acid reflux time and the overall time with pH value <4 in 24 hours after 2 weeks postoperatively in the observation group were significantly lower than those in the control group.The differences were statistically significant (P<0.05); the GerdQ scores of the observation group were significantly lower than those in the control group at the 1st, 3rd and 6th month after operation (P<0.05).

Conclusions

Tubular gastroesophagostomy can significantly reduce the incidence and severity of postoperative GER in patients with middle esophageal cancer.

Key words: Tubular gastroesophagostomy, Full gastroesophagostomy, Gastroesophageal reflux, Esophageal cancer

Chengyu Jin, Duolikun Ailijiang. A comparative study of gastroesophageal reflux after tubular gastroesophagostomy and full gastroesophagostomy for patients with middle esophageal cancer[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2018, 05(03): 164-167.

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References 14

[1]	Shen C, Yang H, Zhang B, et al. Improved quality of life in patients with adenocarcinoma of esophagogastric junction after gastric tube reconstruction[J]. Hepatogastroenterology, 2013, 60(128)：1985-1989.
[2]	Shu YS, Sun C, Shi WP, et al. Tubular stomach or whole stomach for esophagectomy through cervico-thoraco-abdominal approach: a comparative clinical study on anastomotic leakage[J]. Ir J Med Sci, 2013, 182(3)：477-80.
[3]	王金栋，刘俊峰，王其彰，等. 胃食管吻合术后胃食管反流的研究[J]. 中华胸心血管外科杂志，2005, 21(3)：160-162.
[4]	Hu J, Li R, Sun L, et al. Influence of esophageal carcinoma operations on gastroesophageal reflux[J]. Ann Thorac Surg, 2004, 78(1)：298-302.
[5]	Rice TW, Goldblum JR, Rybicki LA, et al. Fate of the esophagogastric anastomosis[J]. J Thorac Cardiovasc Surg, 2011, 141(4)：875-880.
[6]	Dent J, Jones R, Vakil N, et al. A management strategy for GER based on the Gastroesophageal reflux disease questionnaire (GerdQ) [J]. Scand J Gastroenterol, 2008, 43(5): 34-35.
[7]	任杰，冯彩婶，熊云田，等．食管癌术后肺转移的外科治疗临床体会[J]．疑难病杂志，2012，11(5)：377- 378.
[8]	陈文树，付向宁，徐澄澄，等. 管状胃对食管癌手术后胃食管反流的影响[J]. 海南医学，2015, 40(10)：1434-1436.
[9]	车嘉铭，项捷，陈凯，等. 管状胃在食管、贲门癌手术中的临床应用[J]. 中国胸心血管外科临床杂志，2010, 17(2)：96-98.
[10]	何家贤，徐汉杰. 管状胃重建消化道在食管癌切除术中应用的研究进展[J]. 局解手术学杂志，2018，27(2)：152-155.
[11]	鲍峰，宫为一，于在诚. 全胃代食管、缩缝胃小弯及改进管状胃代食管在食管癌术中重建消化道的效果[J]. 中国老年学杂志，2017, 37(6)：1452-1454.
[12]	王连芬. GerdQ量表在胃食管反流病中的诊断价值[D]. 中国医科大学，2011..
[13]	Feng MX, Wang H, Zhang Y, et al. Minimally invasive esophagectomy for esophageal squamous cell carcinoma: a case-control study of thoracoscope versus mediastinoscope assistance[J]. Surg Endosc, 2012, 26(6)：1573-1578.
[14]	丁旭青，陈基升，李国梁，等. 管状胃在食管胃吻合术中的疗效观察[J]. 临床医学，2016, 36(7)：17-19.

一般临床变量		观察组(n＝27)	对照组(n＝29)	t/ χ²值	P值
年龄(±s，岁)		66.9±9.1	67.2±10.4	0.139	0.827
性别[n(%)]		?	?	0.085	0.972
?	男性	16(59.3)	18(62.1)	?	?
?	女性	11(40.7)	11(37.9)	?	?
身高(±s，cm)		168.6±7.1	169.6±8.8	0.203	0.622
体重(±s，kg)		67.2±9.1	66.2±9.7	1.047	0.289
体重指数		24.3±4.1	23.9±4.5	0.386	0.716
TNM分期[n(%)]		?	?	1.790	0.225
?	Ⅱa期	9(33.3)	10(34.5)	?	?
?	Ⅱb期	10(37.0)	10(34.5)	?	?
?	Ⅲ期	8(29.7)	9(31.0)	?	?
病理分型[n(%)]		?	?	2.31	0.125
?	腺癌	7(25.9)	8(27.6)	?	?
?	鳞癌	20(74.1)	21(72.4)	?	?
术前GerdQ(±s，分)		6.9±2.0	7.0±2.5	1.247	0.201

一般临床变量		观察组(n＝27)	对照组(n＝29)	t/ χ²值	P值
年龄(±s，岁)		66.9±9.1	67.2±10.4	0.139	0.827
性别[n(%)]		?	?	0.085	0.972
?	男性	16(59.3)	18(62.1)	?	?
?	女性	11(40.7)	11(37.9)	?	?
身高(±s，cm)		168.6±7.1	169.6±8.8	0.203	0.622
体重(±s，kg)		67.2±9.1	66.2±9.7	1.047	0.289
体重指数		24.3±4.1	23.9±4.5	0.386	0.716
TNM分期[n(%)]		?	?	1.790	0.225
?	Ⅱa期	9(33.3)	10(34.5)	?	?
?	Ⅱb期	10(37.0)	10(34.5)	?	?
?	Ⅲ期	8(29.7)	9(31.0)	?	?
病理分型[n(%)]		?	?	2.31	0.125
?	腺癌	7(25.9)	8(27.6)	?	?
?	鳞癌	20(74.1)	21(72.4)	?	?
术前GerdQ(±s，分)		6.9±2.0	7.0±2.5	1.247	0.201

一般临床变量		观察组(n＝27)	对照组(n＝29)	t值	P值
24h酸反流次数(次)		23.5±7.2	62.7±19.8	9.102	0.000
最长酸反流时间(min)		19.4±5.3	39.5±8.9	3.988	0.003
pH值<4的总时间(min)		68.7±33.3	142.3±48.2	4.285	0.002
术后GerdQ评分(分)		?	?	?	?
?	2周	7.2±3.9	9.0±3.1	0.902	0.120
?	1个月	8.1±3.1	8.9±2.5	7.223	<0.001
?	3个月	7.1±3.0	9.2±2.2	3.591	0.005
?	6个月	7.4±2.1	9.2±3.3	2.601	0.015

一般临床变量		观察组(n＝27)	对照组(n＝29)	t值	P值
24h酸反流次数(次)		23.5±7.2	62.7±19.8	9.102	0.000
最长酸反流时间(min)		19.4±5.3	39.5±8.9	3.988	0.003
pH值<4的总时间(min)		68.7±33.3	142.3±48.2	4.285	0.002
术后GerdQ评分(分)		?	?	?	?
?	2周	7.2±3.9	9.0±3.1	0.902	0.120
?	1个月	8.1±3.1	8.9±2.5	7.223	<0.001
?	3个月	7.1±3.0	9.2±2.2	3.591	0.005
?	6个月	7.4±2.1	9.2±3.3	2.601	0.015

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